Comparison between the Analgesic Effect of Oblique Subcostal and Lateral Approach of Ultrasound-Guided Transverse Abdominis Blocks for Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Abstract

Background: It is widely recognized that the primary benefits of minimally invasive surgery are reduced postoperative discomfort and faster recovery time for physical activities.

Objectives: To assess the efficacy of analgesics for preoperative oblique subcostal transverse abdominis blocks (TAP) and lateral TAP  blocks for cases undergoing elective laparoscopic cholecystectomy (ELLC).

Patients and methods: This was a prospective controlled randomized study performed on 48 cases admitted to the day case surgery  unit of Menoufia University Hospital for whom an ELLC was scheduled. Cases were randomly divided into 3 equal groups using SPSS.  

Results: There wasn't a significant distinction among the 3 groups regarding HR measurements at any time pre- or postoperatively (p >  0.05). There wasn’t significant variation among the three groups as regard end tidal CO₂ measurements at any time intraoperatively (p >  0.05). There wasn’t significant variance among the 3 groups regarding mean arterial blood pressures (MAP) measurements at 30 min intraoperatively, at baseline, 15 min, 4, 6, and 24 h postoperatively (p > 0.05). While there was a significant distinction among the three  groups regarding MAP measurements at 10, 20 min intraoperatively, 2 h, and 12 h postoperatively (p<0.05). 

Conclusion: The utilization of an ultrasound-guided (ESP) block resulted in a greater reduction in postoperative tramadol usage and pain  scores compared to the oblique subcostal transversus abdominis plane block following ELLC surgery.