A comparison of pain-reducing effectiveness using laparoscopic-guided transverse abdominal plane block and port site infiltration in laparoscopic cholecystectomy: A randomized controlled trial.

Abstract

Objective: To compare the effectiveness, in terms of pain score and additional analgesia requirement, using laparoscopic-guided transverse abdominis plane block in comparison to port site infiltration in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Jinnah Hospital, Lahore. Period: Methods: Included 92 patients (46 in each group) undergoing elective laparoscopic cholecystectomy Group A patients received a laparoscopic TA plane block with 40 ml 0.25% bupivacaine, 20 ml in each subcostal region, while group B received 40 ml 0.25% bupivacaine, 10 ml in each port site. The outcomes were assessed at 1^st, 4^th, 12^th, and 24 hours post-operatively. Results: In Group A versus B patients, the mean age was 43.30+10.875 versus 44.22+8.894 years, the mean score at 1 hour was 3.26+0.953 vs 4.09+0.725, at 4 hours was 4.17+0.877 vs 4.87+1.046, at 12 hours was 4.52+0.983 vs 5.35+ 0.822 and at 24 hours 4.52+1.110 vs 5.52+ 1.516, respectively. In Group A vs B, rescue analgesia at 1^st, 4^th, 12^th, and 24 hours was required in 8.7%, 26.1%, 43.5% & 52.1% versus 30.4%, 65.2%, 82.6% & 82.6%, respectively (p<0.05 at all intervals). Conclusion: The laparoscopic-guided transverse abdominal plane block is considerably superior to port site infiltration in terms of pain score and additional analgesia requirement.