Unilateral transversus abdominis plane block and port-site infiltration: Comparison of postoperative analgesic efficacy in laparoscopic cholecystectomy Unilaterale Transversus-abdominis-plane-Blockade und Port-site-Infiltration: Vergleich der postoperativen analgetischen Wirksamkeit bei laparoskopischer Cholezystektomie
Anaesthesist, cilt.69, sa.4, ss.270-276, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 69 Sayı: 4
- Basım Tarihi: 2020
- Doi Numarası: 10.1007/s00101-020-00746-1
- Dergi Adı: Anaesthesist
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.270-276
- Anahtar Kelimeler: Laparoscopic cholecystectomy, Unilateral transversus abdominis plane block, Port-site infiltration, Post-operative analgesia, Opioid consumption
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: To compare the analgesic efficacy of unilateral subcostal transversus abdominis plane (TAP) block with local anesthetic infiltration, applied to the port site in patients undergoing laparoscopic cholecystectomy (LC). Methods: Group T received a unilateral subcostal TAP block, group I received a local anesthetic infiltration at port sites, and group C was the control group. Groups T and I received 20 mL 0.25% bupivacaine. Intravenous patient-controlled analgesia with tramadol was similarly applied to all groups. Postoperative pain levels during rest and cough were evaluated using a numeric rating scale (NRS). Nausea and vomiting were evaluated using postoperative nausea vomiting scores (PONV) at 1, 3, 6, 12 and 24 h and tramadol consumption was also determined. Patient satisfaction was evaluated using a Likert-type scale. Results: Postoperative resting NRS scores were lower in group T than the other groups at 1 h and 12 h (p = 0.007 and p = 0.016), while NRS values during cough were statistically significant at 1 h (p = 0.004). The 24‑h tramadol consumption was different: group T 229 ± 33 mg, group I 335 ± 95 mg, and group C 358 ± 66 mg (p < 0.001). The percentages of patients reporting that they would prefer the applied postoperative pain control method again were 83.3%, 62.5% and 70.8% in groups T, I and C, respectively (p = 0.118). Conclusion: Unilateral subcostal TAP block was superior to local anesthetic infiltration at port sites after LC, in terms of low opioid consumption. Unilateral subcostal TAP block is recommended as part of a multimodal analgesic protocol.