Unilateral Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy for Pain Control Comparison with Conventional Port Site and Peritoneal Infiltration

Muhammad Rashid; Muhammad Imran; Kamil Hussain Qureshi; Kaukab Majeed; Usman Khalid; Habib Ur Rehman

doi:10.51253/pafmj.v73i3.7979

Authors

Muhammad Rashid Department of Anesthesia, Medical Battalion, Kotli Pakistan
Muhammad Imran Department of Anesthesia, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan
Kamil Hussain Qureshi Department of Anesthesia, Combined Military Hospital, Muzaffarabad/National University of Medical Sciences (NUMS) Pakistan
Kaukab Majeed Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Usman Khalid Department of Anesthesia, Combined Military Hospital, Bannu/National University of Medical Sciences (NUMS) Pakistan
Habib Ur Rehman Department of Surgery, Combined Military Hospital, Multan/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i3.7979

Keywords:

Laparoscopic cholecystectomy, Port site and peritoneal infiltration, Ultrasound guided unilateral subcostal transversus abdomenis plane block

Abstract

Objective: To compare image-guided unilateral subcostal transversus abdominis plane (STA) block with infiltration of local anaesthetic both port site and peritoneal for post-operative analgesia for laparoscopic gall bladder surgery.

Study Design: Quasi-experimental study

Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Quetta Pakistan, from Nov 2018 to Apr 2019.

Methodology: The study sample (n=80) was divided into two Groups, one for image-guided subcostal transversus abdominis plane block and the other for peritoneal and port site infiltration of local anaesthetic. Anaesthesia was induced with intravenously administered propofol, atracurium, nalbuphine, and intraoperative non-opioid analgesia with ketorolac following which endotracheal intubation was done. The level of abdominal pain was assessed.

Results: The mean opioid consumption at the 24th post-operative hour was 22.75±8.55 in Group-A and 43.20±11.80 in GroupB. Mean total opioid consumption was 111.40±35.99 and 218.90±63.91 in Group-A and B, respectively. The mean VAS score at the 24th post-operative hour was 1.20±0.96 in Group- A and 3.12±1.63 in Group-B. The results showed a significant mean difference between opioid consumption and VAS pain score at the 24th hour (p<0.05).

Conclusion: The unilateral Subcostal transversus abdominis plane block proved a superior alternative to port site and peritoneal infiltration combined for laparoscopic cholecystectomy.