Evaluating the postoperative pain after laparoscopic-assisted bilateral dual Transversus Abdominis Plane (TAP) block in laparoscopic cholecystectomy.

Abstract

Objective: To evaluate the mean post-operative pain scores of patients undergoing laparoscopic-assisted bilateral dual transversus abdominis plane (TAP) block in laparoscopic cholecystectomy. Study Design: Observational study. Setting: Department of Surgery, Unit 1, Services Hospital Lahore, Pakistan. Period: February 2022 to August 2023. Methods: Non-probability consecutive sampling was used to recruit participants. The study included 60 patients aged 18 to 80 years undergoing elective laparoscopic cholecystectomy for symptomatic gallstones. Selection was restricted to those classified as ASA I and II, regardless of gender. Patients who required conversion to open cholecystectomy, had a known allergy to bupivacaine, were diagnosed with "chronic pain syndrome," or were known alcohol or substance abusers within the past six months were excluded from the study. After obtaining informed consent, the patients were randomly assigned to two groups, Group A and Group B, using a random number table. Patients in Group A received a laparoscopic dual TAP block, while those in Group B did not receive any TAP block. Post-operatively all patients received injection paracetamol 1gram intravenously thrice a day as baseline analgesia. Each patient was followed till 24 hours post-operatively at which postoperative VAS score was noted. The data were entered and analyzed using SPSS version 23.0. Results: Mean age was 46.45 ± 14.06 years with 13 (21.67%) male and 47 (78.33%) female. The mean BMI of the participants was 29.02 ± 3.12 kg/m². The mean duration of surgery was 31.53 ± 5.43 minutes for Group A and 32.63 ± 5.95 minutes for Group B. The mean post-operative VAS score in Group A (laparoscopic dual TAP block) was 1.63 ± 0.85, compared to 4.47 ± 1.07 in Group B (control), with a p-value of 0.001, indicating statistical significance. Conclusions: Postoperative pain score was less after laparoscopic-assisted bilateral dual TAP block in laparoscopic cholecystectomy as compared to controls.