Efficacy of laparoscopic transversus abdominis plane block for elective laparoscopic cholecystectomy in elderly patients

Abstract

Transversus abdominis plane (TAP) block technique seems to off er one of the most effi cient methods for a local pain control. Our aim is to demonstrate the eff ectiveness and safety of TAP block for post-operative pain control under laparoscopic vision in elderly patients during laparoscopic cholecystectomy. Th e patients aged more than 65 years old, who had cholecystectomy due to symptomatic cholelithiasis, were retrospectively evaluated. Th e patients that were operated under general anesthesia + laparoscopic TAP block and those who were operated only under only general anesthesia were compared according to their' age and gender, comorbidities, American Society of Anesthesiologists scores, visual analog scale (VAS) for pain and length of stay in the hospital. Median (±interquartile range) values of post-operative 24 th -hour-VAS for pain was found consecutively 2 (±1-3) in TAP block + group and 3 (±2-5) in TAP block -group. Th e median post-operative 24 th -hour-VAS value in overall patients was three. Patients' VAS values were higher in the TAP block -group with a statistically signifi cant diff erence (p = 0.001). Furthermore, no statistically signifi cant diff erence was found for other parameters in two groups. Th e laparoscopic-guided TAP block can easily be performed and has potential for lower visceral injury risk and shorter operational time. Effi cacy, safety and other advantages (analgesic requirements, etc.) make it an ideal abdominal fi eld block in elderly patients.

Laparoscopic Transversus Abdominal Plane Block is Effective in Multimodal Analgesia for Laparoscopic Sleeve Gastrectomy

“…When Tihan et al (17) reaserched the effectiveness of laparascopic TAP block on VAS scores on patients who are olther than 65 and heve undergone laparoscopic cholecystectomy, have similar results as our study. VAS scores were lower in the TAP block administered group than the control group and this was statistically significant (17).…”

“…When Tihan et al (17) reaserched the effectiveness of laparascopic TAP block on VAS scores on patients who are olther than 65 and heve undergone laparoscopic cholecystectomy, have similar results as our study. VAS scores were lower in the TAP block administered group than the control group and this was statistically significant (17). Moreover, in a study, in which 40 elective caesarean patients divided in two groups as USG guided TAP block performed and without TAP block, it was also shown that post operative VAS scores were statistically significantly lower in TAP block group than the controle group (18).…”

Laparoscopic-guided transversus abdominis plane block versus trocar site local anesthetic infiltration in gynecologic laparoscopy

“…Afterward, Chetwood et al [23] used a similar method following laparoscopic nephrectomy which was safe and time saving. In addition, laparoscopic-guided TAP block has reduced postoperative pain scores after laparoscopic cholecystectomy [24,25] and laparoscopic ventral hernia repair [26].…”

Pethidine efficacy in achieving the ultrasound-guided oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy: A prospective study

“…For the sample size calculation, a minimum difference of 2 between two VAS measurements was considered, assuming a standard deviation of 2, per group. The previous studies found a 1.3 standard deviation for TAP [23] and an interquartile range of 2 to 3 [4]. To randomize patients into the groups, a 1:1 allocation ratio was used for a power of 80%, and hypotheses tested at alpha level (p-value) of 0.017, using the Bonferroni correction to adjust the 0.05 level of confidence three times, since three comparisons for the three groups were done.…”

“…The laparoscopic cholecystectomy is a minimally invasive, widespread surgical procedure, associated with postoperative pain of moderate intensity in the early postoperative period. The pain reaches its peak within the first few hours after surgery and diminishes during the next two to three days [1][2][3][4]. There are several approaches to postoperative pain management after laparoscopic cholecystectomy, such as intravenous patient-controlled analgesia with opioids (IV-PCA), neuraxial blocks, intraperitoneal local anesthesia, and wound infiltration.…”