title: A randomised controlled trial investigating the analgesic efficacy of transversus abdominis plane block for adult laparoscopic appendicectomy.
abstract: We conducted a single-centre, prospective randomised clinical trial to investigate the analgesic efficacy of transversus abdominis plane (TAP) block in adult patients undergoing laparoscopic appendicectomy.
  
  
  
  Patients undergoing urgent laparoscopic appendicectomy under general anaesthesia alone (control group) and general anaesthesia supplemented by TAP block (TAP intervention group) were compared. All patients received a multimodal analgesia regime, which included postoperative morphine via a patient-controlled analgesia device. The primary endpoints were morphine consumption at 12 hours and 24 hours postoperatively. Secondary endpoints included pain scores, incidence of nausea and vomiting, and time to hospital discharge. A total of 58 patients were recruited, with 29 patients in each group.
  
  
  
  Mean postoperative morphine consumption at 12 hours (control group: 11.45 ± 7.64 mg, TAP intervention group: 9.79 ± 8.09 mg; p = 0.4264) and 24 hours (control group: 13.38 ± 8.72 mg, TAP intervention group: 11.31 ± 8.66 mg; p = 0.3686) for the control and TAP intervention groups were not statistically different. Secondary outcomes were also not different between the two groups. Length of stay in the post-anaesthesia care unit was significantly shorter for the TAP intervention group, with a trend toward faster hospital discharge being observed.
  
  
  
  TAP block, a regional anaesthetic procedure performed immediately prior to skin incision for laparoscopic appendicectomy, did not significantly improve postoperative analgesia outcomes.
authors.affiliation: Department of Anaesthesia, Ng Teng Fong General Hospital, JurongHealth, Singapore.
authors.forename: Darell Alexander
authors.initials: DA
authors.lastname: Tupper-Carey
authors.affiliation: Department of Anaesthesia, Ng Teng Fong General Hospital, JurongHealth, Singapore.
authors.forename: Shahridan Mohd
authors.initials: SM
authors.lastname: Fathil
authors.affiliation: Department of Anaesthesia, Ng Teng Fong General Hospital, JurongHealth, Singapore.
authors.forename: Yin Kiat Glenn
authors.initials: YK
authors.lastname: Tan
authors.affiliation: Department of Surgery, Ng Teng Fong General Hospital, JurongHealth, Singapore.
authors.forename: Yuk Man
authors.initials: YM
authors.lastname: Kan
authors.affiliation: Department of Surgery, Ng Teng Fong General Hospital, JurongHealth, Singapore.
authors.forename: Chern Yuen
authors.initials: CY
authors.lastname: Cheong
authors.affiliation: Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.|Singapore Clinical Research Institute, Singapore.
authors.forename: Fahad Javaid
authors.initials: FJ
authors.lastname: Siddiqui
authors.affiliation: Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.|Singapore Clinical Research Institute, Singapore.
authors.forename: Pryseley Nkouibert
authors.initials: PN
authors.lastname: Assam
mesh_terms: D000009:Abdominal Muscles / Q000294:innervation; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods; D001062:Appendectomy / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control
chemical_list: D009020:Morphine
keywords: laparoscopic appendicectomy; postoperative analgesia; regional anaesthesia; transversus abdominis plane block