Is TAP block better than bupivacaine spray for relieving post-cholecystectomy pain?

Abstract

Introduction: The choice of anesthetic is a determinant of post-cholecystectomy pain perception by patients. The efficacy of Transversus Abdominis Plane (TAP) block in reducing such pain needs to be investigated.

Objectives: To compare the mean postoperative pain scores of TAP block and intraperitoneal bupivacaine spray in patients undergoing laparoscopic cholecystectomy for chronic cholecystitis.

Materials & Methods: This comparative study was carried out at Al-Tibri Medical College and Hospital, Karachi, from 15 June 2023 to 15 December 2023, after approval from hospital ethical committee. All patients aged 18-65 years of both genders, diagnosed with chronic cholecystitis were included in the study. A total of 112 patients were selected using nonprobability, consecutive sampling, with 56 patients in each group. Laparoscopic cholecystectomy was done in both groups: Group A was given TAP block, Group B was given intraperitoneal bupivacaine spray, and post-operative pain was compared in both groups. SPSS 22 was utilized for descriptive and comparative statistics, with p≤0.05 denoting significance.

Results: The mean age of 112 enrolled patients was 33.53±5.1 years. There were 29 (25.9%) males and 83 (74.1%) females. Age, gender distribution, height, weight, and body mass index were almost the same in both groups. VAS score in group B was 3.75±2.2 at 2 hours, 3.63±2.1 at 6 hours, 3.46±1.7 at 12 hours and 3.3±1.01 after 24 hours of surgery. In group A VAS was 4.10±1.9 at 2 hours, 3.95±1.6 at 6 hours, 3.02±1.2 at 12 hours and 2.10±1.3 after 24 hours of surgery. When 24-hour post-operative pain was compared in both groups pain was significantly lower in group A (TAP block) with p-value <0.001.

Conclusion: TAP block is associated with decreased post-operative pain as compared with intraperitoneal bupivacaine spray.