Subcostal transversus abdominis plane block can improve analgesia after laparoscopic cholecystectomy

Vrsajkov, Vladimir; Mancic, N.; Mihajlović, D; Milićević, Suzana Tonković; Uvelin, Arsen; Vrsajkov, Jelena Pantić

doi:10.1016/j.bjane.2017.10.007

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…Vrsajkov et al observed that the mean pain scores by Numerical Rating Scale (NRS) were significantly lesser in patients who received subcostal TAP than the standard analgesia group at every time point following laparoscopic cholecystectomy. 15 In various other studies on laparoscopic cholecystectomy, subcostal TAP reduced VAS pain scores significantly more than port site infiltration 16 and posterior TAP block. 17 Subcostal TAP was also found comparable to paravertebral block in reducing VAS scores after open cholecystectomy.…”

Section: Discussionmentioning

confidence: 89%

Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy – A Randomized Controlled Trial

Saravanan

Venkatraman

Karthika

2021

LRA

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Background and Aims Subcostal Transversus Abdominis Plane (TAP) block is the standard practice for postoperative analgesia following laparoscopic cholecystectomy. This study aimed to compare the efficacy of modified BRILMA Block (blocking the BRanches of Intercostal nerves at the Level of Mid-Axillary line) with Subcostal TAP block for pain relief following laparoscopic cholecystectomy. Methods Sixty cases scheduled for laparoscopic cholecystectomy were randomly divided into two groups: modified BRILMA block (Group B) and Subcostal TAP block (Group T). General anesthesia was standardized for both groups. Blocks were performed with 20 mL of 0.2% Ropivacaine under ultrasound guidance after induction of anesthesia. Patients were administered morphine through patient controlled analgesia (PCA) pump with a bolus dose of 1 mg, 10 min lockout interval, and a basal infusion rate of 0.1 mg/h. The pain was assessed by the Visual Analog Scale (VAS) scores of one to ten. The total morphine consumption, time to first request for rescue analgesia, and VAS scores at rest and with movement, and complications, if any, were recorded. Results The morphine consumption in Group B was 5.67 ± 1.98 mg and in Group T was 5.17 ± 1.85 mg, which was found to be statistically insignificant (p-value = 0.317). The time to first request for rescue analgesia was 759.33 ± 80.29 min in Group B which was comparable to 854 ± 93.01 min in Group T and statistically insignificant (p-value = 0.295). The average VAS scores at rest as well as on movement were comparable in both the groups during the entire 24 h postoperative period. No complications were encountered in our study. Conclusion Ultrasound-guided modified BRILMA block is equally efficacious as subcostal TAP block in providing postoperative analgesia with similar morphine consumption and no significant difference in VAS scores at rest and movement following laparoscopic cholecystectomy. Trial Registration Number CTRI/2020/02/023457.

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Section: Discussionmentioning

confidence: 89%

Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy – A Randomized Controlled Trial

Saravanan

Venkatraman

Karthika

2021

LRA

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“…There are several studies evaluating the effects of the TAP block on pain after laparoscopic cholecystectomy with varying results. 4,5,29,30 El-Dawlatly et al 4 reported that a lateral TAP block reduced intraoperative and postoperative analgesic demands, and Vrsajkov et al 6 reported that a bilateral subcostal TAP block reduced the postoperative pain score and tramadol consumption, but Houben et al 30 reported that a bilateral subcostal TAP block did not reduce the pain score and dose of analgesics required except the volume of intraoperative sevoflurane. The lateral TAP block can only block the anterior division of the thoracolumbar nerve from T10 to L1.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 However, the subcostal TAP block showed consistent results in laparoscopic cholecystectomy. [6][7][8][9] In addition, the combination of these 2 blocks, known as the bilateral dual TAP (BD-TAP), was also shown to reduce pain score and opioid consumption. 10 Current evidence indicates that the subcostal TAP is superior to the lateral TAP in laparoscopic cholecystectomy.…”

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confidence: 99%

Impact of Bilateral Subcostal Plus Lateral Transversus Abdominis Plane Block on Quality of Recovery After Laparoscopic Cholecystectomy: A Randomized Placebo-Controlled Trial

Jung

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND: Previous research has not evaluated the potential effect of transversus abdominis plane (TAP) block on quality of recovery following laparoscopic cholecystectomy. Therefore, we investigated whether addition of the bilateral subcostal and lateral TAP (bilateral dual TAP [BD-TAP]) blocks to multimodal analgesia would improve the quality of recovery as assessed with the Quality of Recovery-40 (QoR-40). METHODS: Patients age 18 to 60 years who were scheduled to undergo elective laparoscopic cholecystectomy were randomized to the BD-TAP or control group. The BD-TAP group received the BD-TAP block with multimodal analgesia under general anesthesia, using 0.25% ropivacaine, and the control group was treated with the same method, except that they received the sham block using 0.9% normal saline. Both groups had the same multimodal analgesia regimen, consisting of intravenous dexamethasone, propacetamol, ibuprofen, and oxycodone. The primary outcome was the QoR-40 score at 24 hours after surgery. Data were analyzed using the independent t test, Mann-Whitney U test, χ2 test, and Fisher exact test. RESULTS: Thirty-eight patients in each group were recruited. The mean QoR-40 score decreased by 13.6 (95% confidence interval [CI], 8.3–18.8) in the BD-TAP group and 15.6 (95% CI, 6.7–24.5) in the control group. The postoperative QoR-40 score at 24 hours after surgery did not differ between the 2 groups (BD-TAP group, median [interquartile range], 170.5 [152–178]; control group, 161 [148–175]; median difference, 3 [95% CI, −5 to 13]; P = .427). There were no differences between the 2 groups in the pain dimension of the QoR-40: 30.5 (95% CI, 27–33) in the BD-TAP group and 31 (95% CI, 26–32) in the control group; median difference was 0 (95% CI, −2 to 2); P = .77. CONCLUSIONS: Our results indicate that the BD-TAP block does not improve the quality of recovery or analgesic outcomes following laparoscopic cholecystectomy. Our results do not support the routine use of the BD-TAP block for this surgery.

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“…Another study was done by Vrsajkov et al 9 aboutusing subcostal TAPB to improve analgesia after laparoscopic cholecystectomy.This study was done to investigate influence of subcostal TAPB on postoperative pain score and opioid consumption.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Guided Subcostal Transversus Abdominis Plane Block For Postoperative Analgesia After Laparoscopic Cholecystectomy ( comparative Study Between Bubivacaine Versus Bubivacaine-Ketamine)

Ahmed

2020

Al-Azhar International Medical Journal

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Background: Laparoscopic cholecystectomy is the surgery to remove the gall bladder and is the common treatment of symptomatic gall stone and other GB conditions. Laparoscpic cholecystectomy can be carried out under general anaesthesiathat is often related to chronic postoperative pain. Aim of work: Study Compares between adding ketamine to bupivacaine and bupivacaine alone for postoperative pain in patients undergoing ultrasound guided subcostal transversus abdominis plane block (TAPB) after laparoscopic cholecystectomy; time of first application for extra analgesia, pain Ratings, gross analgesic intake and analgesic effectiveness. Patient and Methods: This research was performed out on 28 patient's ages 30 to 60 years at Al-Azhar University hospital.Class I-II American Anesthesiologist Society (ASA) scheduled for laparoscopic cholecystectomy. Patients were randomized, monitored double blind into two similar groups (fourteen people each). Results: The Comparison between the two studied groups was statistically insignificant according tothe period before first opioids demand, the block lenght, opioids demand, early ambulation, patient's satisfaction and occurrence of vomiting and nausea. As regarding patient complication there was no local anaesthetic toxicity in both groups of hematoma or severe tissue damage at the injection site. Conclusion: Adding of ketamine to bupivacaine in patients with ultrasound-guided subcostal TAPB for laparoscopic cholecystectomy results in statistically insignificant in the following: longer span before first opioid requirement and prolonged block duration, less opioid demand, early ambulation and the patient is being more satisfied.

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Subcostal transversus abdominis plane block can improve analgesia after laparoscopic cholecystectomy

Cited by 5 publications

References 16 publications

Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy – A Randomized Controlled Trial

Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy – A Randomized Controlled Trial

Impact of Bilateral Subcostal Plus Lateral Transversus Abdominis Plane Block on Quality of Recovery After Laparoscopic Cholecystectomy: A Randomized Placebo-Controlled Trial

Ultrasound Guided Subcostal Transversus Abdominis Plane Block For Postoperative Analgesia After Laparoscopic Cholecystectomy ( comparative Study Between Bubivacaine Versus Bubivacaine-Ketamine)

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