Cholelithiasis, Pain, Postoperative
Conditions
Keywords
Laparoscopic Cholecystectomy, TAP Block, Post Operative Pain, Gallbladder, Post Operative Opioid Consumption, Visual Analog Scale, ERAS
Brief summary
This study compares the effectiveness of a Transversus Abdominis Plane (TAP) block in reducing post-operative pain for patients undergoing laparoscopic cholecystectomy. Sixty patients were divided into two groups: one group received a TAP block with a local anesthetic at the end of surgery, and the control group did not. The main goal was to see if the TAP block significantly lowers pain scores (measured on a scale of 0 to 10) within the first 12 hours after surgery and if it reduces the need for additional pain-relief medications.
Detailed description
Laparoscopic cholecystectomy is the gold standard for treating symptomatic cholelithiasis; however, patients often experience significant in the early post-operative period. This randomized controlled trial (RCT) was conducted at the Department of Surgery, Liaquat College of Medicine & Dentistry, Karachi, to evaluate the analgesic efficacy of the TAP block. A total of 60 patients, aged 18-60 years with ASA I or II, were randomized into two equal groups (n=30 each). The intervention group received an TAP block while the control group received standard post-operative analgesia. The primary objective was to compare the mean Visual Analog Scale (VAS) score at 12 hours post-operation. Secondary objectives included assessing the time to the first request for rescue analgesia and the type of analgesic drug used. Data were analyzed to determine if the TAP block provides superior pain control compared to conventional methods.
Interventions
DRUGBupivacaine 0.25%
Transversus Abdominis Plane (TAP) block administered by injecting 20ml of 0.25% Bupivacaine between the internal oblique and transversus abdominis muscles.
Patients received the routine post-operative analgesia protocol of the hospital (e.g., IV Ketorolac or Paracetamol) without the administration of a TAP block
Sponsors
Darul Sehat Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18-60 years * Both genders * Patients diagnosed with Cholelithiasis in accordance with operational definition and planned to undergo Laparoscopic Cholecystectomy
Exclusion criteria
* Patients with ASA of ≥ 3 * Patients diagnosed with acute cholecystitis, empyema, mucocele or perforated gall bladder * Patients planned to undergo laparoscopic cholecystectomy alongside other abdominal procedures * Patients with body mass index of ≥ 35 Kg/m2 * Patients with history of coagulation disorders like hemophilia or those with history of anti-platelet drugs use in last 2 weeks * Pregnant females
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) Score for Pain | 12 hours post-operation | A subjective psychometric response scale used to measure pain intensity. It consists of a 10 cm line where 0 represents "no pain" and 10 represents "the worst pain imaginable.". |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time for First Request of Rescue Analgesia | Within the first 24 hours post-operation. | The duration of time (in hours or minutes) from the end of the surgical procedure until the patient first requests additional pain medication due to inadequate pain control. |
Countries
Pakistan
Outcome results
None listed