Comparative study of ultrasound-guided abdominal field blocks versus port infiltration in laparoscopic cholecystectomies for post-operative pain relief.
OBJECTIVE
Post-operative pain is a major concern for day care surgeries like laparoscopic cholecystectomy. This study aimed to compare the efficacy of ultrasound guided abdominal field blocks (USAFB) with port site infiltrations for post-operative analgesia in terms of quality of pain relief, opioid consumption and patient satisfaction for day care surgeries.


METHODS
Eighty patients presenting for laparoscopic cholecystectomy were randomly allocated to two groups either to receive port-site infiltration of local anaesthetic (n = 40, Group A) or USAFB (n = 40, Group B group). Numeric rating scores (NRS) were measured postoperatively to primarily assess the pain severity and opioid requirements. Data were analysed using Chi-Square test/Fisher's exact test for categorical data and Mann-Whitney test/unpaired t-test for quantitative data.


RESULTS
The study group (Group B) had significantly reduced NRS and opioid consumption over 24 h. The overall fentanyl consumption in patients receiving port infiltrations was approximately twice (200 ΁ 100 μg) as compared to patients in USAFB group (120 ΁ 74 μg) (P < 0.0001). Maximum fentanyl consumption was 400 μg (Group A) and 262 μg (Group B) over 24 h and the minimum requirement was 50 μg and zero, respectively.


CONCLUSIONS
Superior post-operative analgesia was observed with USAFB which may help in minimising opioid-related adverse effects and facilitating faster recovery.
Department of Anaesthesiology, Dr. B L Kapur Superspeciality Hospital, Rajinder Nagar, New Delhi, India.
Ruchi
R
Saxena
Department of Anaesthesiology, Dr. B L Kapur Superspeciality Hospital, Rajinder Nagar, New Delhi, India.
Saurabh
S
Joshi
Department of Community Medicine, TSM Medical College and Hospital, Lucknow, Uttar Pradesh, India.
Kuldeep
K
Srivastava
Department of Anaesthesiology, Dr. B L Kapur Superspeciality Hospital, Rajinder Nagar, New Delhi, India.
Shashank
S
Tiwari
Department of Anaesthesiology, Dr. B L Kapur Superspeciality Hospital, Rajinder Nagar, New Delhi, India.
Nitin
N
Sharma
Department of Anaesthesiology, Dr. B L Kapur Superspeciality Hospital, Rajinder Nagar, New Delhi, India.
Umesh K
UK
Valecha
Laparoscopic cholecystectomy; post-operative analgesia; rectus sheath block; subcostal transversus abdominis block