Comparison of laparoscopic-guided versus ultrasound-guided TAP block in laparoscopic cholecystectomy




Nilay T. Uzunay, Department of General Surgery, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
Tarkan Mingir, Department of Anesthesiology and Intensive Care; Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
Ergin Erginoz, Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa. Istanbul, Turkey
Dursun O. Karakas, Department of General Surgery, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
Emin Kose, 3Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa. Istanbul, Turkey


Introduction: Transversus abdominis plane (TAP) block is a widely used anesthetic technique of the abdominal wall, where ultrasound guidance is considered the gold standard. In this study, we aimed to compare the effectiveness of laparoscopic-assisted TAP (LTAP) block with ultrasound-assisted TAP (UTAP) block for post-operative pain, nausea, vomiting, duration of the block, and bowel function. Materials and methods: This study included 60 patients who were randomly assigned to two groups to undergo either the LTAP or UTAP block technique after laparoscopic cholecystectomy. The time taken for administering the block, post-operative nausea and vomiting, post-operative pain, respiratory rate, bowel movements, and analgesia requirements were reported. Results: The time taken for the LTAP block was shorter (p < 0.001). Post-operative mean tramadol consumption, paracetamol consumption, and analgesic requirement were comparable between the two groups (p = 0.76, p = 0.513, and p = 0.26, respectively). The visual analog scale at 6, 24, and 48 h was statistically not significant (p = 0.632, p = 0.802, and p = 0.173, respectively). Nausea with vomiting and the necessity of an antiemetic medication was lower in the UTAP group (p = 0.004 and p = 0.009, respectively). Conclusion: The LTAP block is an easy and fast technique to perform in patients as an alternative method where ultrasound guidance or an anesthesiologist is not available.



Keywords: Laparoscopic cholecystectomy. Transversus abdominis plane block. Perioperative analgesia. Visual Analog Scale. Pain.