Advertisement!
Author Information Pack
Editorial Board
Submit article
Special Issue
Editor's selection process
Join as Reviewer/Editor
List of Reviewer
Indexing Information
Most popular articles
Purchase Single Articles
Archive
Free Online Access
Current Issue
Recommend this journal to your library
Advertiser
Accepted Articles
Search Articles
Email Alerts
FAQ
Contact Us
Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 3, May-June 2019, Pages 769-776
 

Original Article

Comparing the Postoperative Analgesic Effect of Subcostal Transverse Abdominis Plane Block and Intraperitoneal Installation using Ropivacaine in Laparoscopic Cholecystectomy Patients

Saraswathi Nagappa1, Satish Kumar MN2, Sandhya K3, Raghavendra Rao RS4

1,2Assistant Professor, 3Professor 4Professor and Head, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India.

Choose an option to locate / access this Article:
60 days Access
Check if you have access through your login credentials.        PDF      |
|

Open Access: View PDF

DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.11

Abstract

 Background: Laparoscopic cholecystectomy is one of the most common ambulatory elective procedures. Surgical pain derives significantly from the incisions made in the anterior abdominal wall. Nerve supplying the anterior abdominal wall are derived from T6-L1 afferent nerve which course through the neurofascial plane between the internal oblique and transversus abdominis muscle. The subcostal transverse abdominis plane (TAP) block is better suited for upper abdominal surgery [T7-T11] in relieving postoperative pain. Materials and Methods: 60 patients were randomly allocated into any one of two groups of 30 patients each, by means of computer-generated randomization. Group A patients received bilateral subcoastal TAP block with Ropivacaine 0.25% 40 ml injected under ultrasound guidance. Group B patients received intraperitoneal installation of Ropivacaine 0.25% 40 ml through laparoscopic instrument before laparoscopic port closure. Results: Resting VAS scores were significantly lower in group A than B at 4 hr (p=0.003), 8 hr (p=0.001), 12 hr (p=0.001) and 24 hr (0.001) after the operation. Deep inspiration VAS scores were significantly lower in group A than B at 4 hr (p=0.003), 8 hr (p=0.001), 12 hr (p=0.001) and 24 hr (<0.001) after the operation. Both static and dynamic pain were accompanied by lower analgesic requirement in the subcostal TAP block. Conclusion: Ultrasound guided subcostal TAP block is one of the most effective supplemental techniques as part of the multimodal post-operative analgesic regimen.


Keywords : Subcostal block; Analgesia; Intraperitoneal; Laproscopy; Ropivacaine.
Corresponding Author : Satish Kumar MN