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

Abstract

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.

Ketamine versus Dexmedetomidine in Local Wound Infiltration for Postoperative Pain Relief in Cesarean Section

“…On the contrary, Medhat et al [15] reported no difference between the study groups regarding the time of the first analgesic request and opioid consumption in the subcostal transversus abdominis plane block in laparoscopic cholecystectomy. This may be attributed to the use of a small dose of ketamine [0.5 mg/kg] while we used [2 mg/kg] in our study.…”

“…On the contrary, Medhat et al [15] reported that insignificant difference was found between bupivacaine versus bupivacaine ketamine groups regarding visual analogue scale after laparoscopic cholecystectomy.…”