Postoperative analgesic efficacy of single-shot and continuous transversus abdominis plane block after laparoscopic cholecystectomy: A randomized controlled clinical trial.

Abstract

STUDY OBJECTIVE:

To compare the analgesic efficacy of ultrasound-guided single-shot and continuous transversus abdominis plane (TAP) block to that of IV-PCA in patients undergoing laparoscopic cholecystectomy.

DESIGN:

Prospective randomized controlled trial.

SETTING:

Post-anesthesia care unit and General ward.

PATIENTS:

108 American Society of Anesthesiologist (ASA) physical status I-II patients undergoing laparoscopic cholecystectomy.

INTERVENTIONS:

Group A received IV-PCA; group B received both ultrasound-guided single-shot TAP block with 0.2% ropivacaine (20mL) and IV-PCA; and group C received continuous TAP block using an ultrasound-guidance-inserted indwelling catheter. In group C, infusion of 0.2% ropivacaine at a basal rate of 3mL/h, bolus dose of 4mL, and a lockout interval of 30min was maintained for 48h postoperatively. The primary outcome was evaluated analgesic efficacy using the numeric rating scale (NRS) for 48h postoperatively. Other outcomes included the number of patients requiring additional analgesics, patient satisfaction with postoperative pain control, and incidence of postoperative adverse events.

MAIN RESULTS:

Compared to other groups, group C had higher deep abdominal NRS at 1h postoperatively (P<0.05), and lower incidence of postoperative urinary retention (P<0.05). There were no significant intergroup differences in the number of patients requiring additional analgesics, and patient satisfaction with postoperative pain control.

CONCLUSIONS:

Compared to IV-PCA with or without single-shot TAP block, ultrasound-guided continuous TAP block provided similar analgesia in somatic pain and less analgesia in visceral pain. Moreover, the latter resulted in a lower incidence of postoperative urinary retention.

• Authors: Yun-Mi Choi, Gyeong-Jo Byeon, Soon-Ji Park, Young-Min Ok, Sang-Wook Shin, Kwangho Yang
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 39 Pg. 146-151 (Jun 2017) ISSN: 1873-4529 [Electronic] United States
• PMID: 28494892 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Chemical References

• Amides
• Anesthetics, Local
• Ropivacaine

Topics

• Abdominal Muscles (diagnostic imaging)
• Adult
• Aged
• Amides (administration & dosage)
• Analgesia, Patient-Controlled (methods)
• Anesthetics, Local (administration & dosage)
• Cholecystectomy, Laparoscopic (methods)
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Nerve Block (methods)
• Pain, Postoperative (epidemiology)
• Patient Satisfaction
• Postoperative Complications (epidemiology)
• Prospective Studies
• Ropivacaine
• Ultrasonography, Interventional
• Urinary Retention (epidemiology)
• Young Adult