title: Bilateral transversus abdominis plane block does not decrease postoperative pain after laparoscopic cholecystectomy when compared with local anesthetic infiltration of trocar insertion sites.
abstract: OBJECTIVE
  Transversus abdominis plane (TAP) block has been shown to reduce pain and analgesic requirements after abdominal surgery. Our hypothesis was that bilateral TAP blocks decrease pain after laparoscopic cholecystectomy when compared with local anesthetic infiltration of trocar insertion sites.
  
  
  METHODS
  Eighty patients undergoing laparoscopic cholecystectomy were randomized to receive either bilateral TAP blocks or local anesthetic infiltration of trocar insertion sites with ropivacaine 0.5%. Postoperative pain scores and analgesic use for the first 24 hrs were recorded.
  
  
  RESULTS
  Eighty patients were enrolled in the study. After exclusions, data were analyzed on 39 patients in group T (bilateral TAP block) and 35 patients in group I (infiltration). There was no statistically significant difference in pain scores on the numeric analog scale (0-10) between the groups at 4 hrs after surgery (P = 0.18) or during the 24 hrs after surgery (P = 0.23). The time interval from anesthesia start to surgery start was greater in group T than group I (48 vs 35 mins, P < 0.001). There was no significant difference found in analgesic use during the first 24 hrs after surgery.
  
  
  CONCLUSIONS
  Bilateral ultrasound-guided TAP block is equivalent to local anesthetic infiltration of trocar insertion sites for overall postoperative pain in a heterogeneous group of patients undergoing laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX 77030, USA. jaimeo@bcm.edu
authors.forename: Jaime
authors.initials: J
authors.lastname: Ortiz
authors.forename: James W
authors.initials: JW
authors.lastname: Suliburk
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wu
authors.forename: Neil S
authors.initials: NS
authors.lastname: Bailard
authors.forename: Chawla
authors.initials: C
authors.lastname: Mason
authors.forename: Charles G
authors.initials: CG
authors.lastname: Minard
authors.forename: Raja R
authors.initials: RR
authors.lastname: Palvadi
mesh_terms: D000009:Abdominal Muscles / Q000187:drug effects* / Q000502:physiology; D000328:Adult; D000772:Anesthesia, Local / Q000295:instrumentation* / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000295:instrumentation / Q000379:methods; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013525:Surgical Instruments
chemical_list: D000779:Anesthetics, Local