การศึกษาเปรียบเทียบอาการปวดหลังผ่าตัดในผู้ป่วยที่เข้ารับการผ่าตัด Laparoscopic Cholecystectomy ที่ได้รับการทำ Ultrasound-guided Transversus Abdominis Plane Block กับผู้ป่วยที่ได้รับยาแก้ปวด Opioids อย่างเดียว

Pornpawee  Kaewprakop

Authors

Pornpawee Kaewprakop Kalasin Hospital

Keywords:

Transversus Abdominis Plane Block, Laparoscopic Cholecystectomy, Postoperative Pain, Opioids, Ultrasound

Abstract

Background: Minimal Invasive Surgery (MIS), particularly Laparoscopic Cholecystectomy, is increasingly common. Effective postoperative pain management is crucial for enhanced recovery. This study compares the efficacy of Ultrasound-guided Transversus Abdominis Plane (TAP) block versus opioid analgesia alone for postoperative pain control in Laparoscopic Cholecystectomy.

Methods: A prospective, randomized, controlled trial was conducted on 62 patients undergoing elective Laparoscopic Cholecystectomy. Patients were randomized to either a TAP block group (TAP) or a control group receiving opioids alone (NON-TAP). The TAP group received bilateral ultrasound-guided TAP blocks with a mixture containing 20 mL of 0.5% bupivacaine, 20 mL of 2% xylocaine with adrenaline (1:200,000), 1 mL of dexamethasone (4 mg), and 19 mL of normal saline, totaling 60 mL. The anesthesiologist will divide into 15 mL injections for each site (subcostal and lateral TAP block). Postoperative pain scores, opioid consumption, and side effects were assessed.

Results: The TAP group demonstrated significantly lower total morphine consumption (9.3 ± 2.7 mg) compared to the NON-TAP group (14.1 ± 3.6 mg; p-value<0.01). Intraoperative and postoperative morphine consumption was also significantly reduced in the TAP group (p-value< 0.01). Pain scores at rest and during movement in the PACU were significantly lower in the TAP group (p-value< 0.01). There was no significant difference in the incidence of postoperative nausea and vomiting.

Conclusion: Ultrasound-guided TAP block effectively reduces postoperative pain and opioid consumption in patients undergoing Laparoscopic Cholecystectomy.

Keywords: Transversus Abdominis Plane Block, Laparoscopic Cholecystectomy, Postoperative Pain, Opioids, Ultrasound

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