A Comparative Study to Evaluate the Effectiveness of Perioperative Multi Modal Analgesia with Ultrasound Guided Bilateral Subcostal TAP Block for Post-Operative Analgesia in Patients undergoing Elective Laparoscopic Cholecystectomy under General Anaesthes

Radhika Dhanpal; Shwetha K Mudalagirigowda; Deepika K  Chandrashekar

doi:10.18502/aacc.v9i3.13122

Radhika Dhanpal Department of Anaesthesiology, Vydehi Institute of Medical Sciences, Bangalore, Karnataka,India.
Shwetha K Mudalagirigowda Department of Anaesthesiology, Vydehi Institute of Medical Sciences, Bangalore, Karnataka,India.
Deepika K Chandrashekar Department of Anaesthesiology, Vydehi Institute of Medical Sciences, Bangalore, Karnataka,India.

DOI: https://doi.org/10.18502/aacc.v9i3.13122

Keywords: Transversus abdominis plane block; Bupivacaine; Dexamethasone; Pregabalin; Laparoscopic cholecystectomy; Post-operative analgesia

Abstract

Background: Laparoscopic cholecystectomy is usually performed as a day care procedure for diseases involving the gall bladder. Pain in the immediate post-operative period is due to multiple factors and hence different modalities of pain relief are used. The present study was conducted to study the effectiveness of Peri-operative Multi-Modal Analgesia with ultrasound guided bilateral subcostal TAP block for Post-operative analgesia in 60 patients undergoing elective laparoscopic cholecystectomy.

Methods: In this hospital based, randomized prospective interventional study patients were randomly allocated into 4 groups of 15 in each group, Group B received Bilateral Ultrasound guided Subcostal TAP Block with 20 ml of 0.25% Bupivacaine, Group P received Tab Pregabalin tablet 150 mg, Group D received Inj Dexamethasone 8 mg IV and Group C was the control group. The hemodynamic changes like heart rate, blood pressure, saturation was monitored both intra and post operatively. The post-operative VAS scoring, duration of analgesia, time for first rescue analgesic and the total dose of analgesics in 24 hours were noted.

Results: The VAS Scores indicated that Group B> P> D> C provided better analgesia to the patients with a P Value of < 0.01. Group B took the longest mean duration (6.8± 1.15 hours) to take the 1st rescue analgesic and least mean total dose of rescue analgesic in 24 hours followed by Group P, Group D and Group C which was statistically significant.

Conclusion: USG guided B/L TAP Block was superior to other modalities in providing postoperative analgesia for patients undergoing laparoscopic cholecystectomy.