Comparison of Ultrasound-guided Transversus abdominis plane block and opioid on pain for postoperative analgesia in Laparoscopic surgery in Krabi hospital : A randomized controlled trail

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Pokchat Wanich


Randomized controlled trial, aim to compare visual analog pain scale, opioid consumption and opioid side effect in TAP block versus NON TAP block in 24 hr after laparoscopic surgery. Include 50 patients undergo elective laparoscopic surgery since 1 November 2021 to 30 April 2022 then randomize in 2 groups by Block randomized method; TAP block and NON TAP block. Bilateral Subcostal and Posterior TAP block with Ultrasound-guided used 0.15% bupivacaine 15ml per side (total 60 ml) were performed in TAP block group. Pain score at rest and movement at 0,2,6,24 hr postoperative in 2 groups were recorded. The data of opioid consumption, incidence of PONV in 2 groups were also collected. Data are presented as mean ± standard deviation or the median and interquartile range for continuous data and percentages for categorical variables. Inference statistics is calculated by Mann-Whitney U-test

            Results : Pain score in TAP block versus NON TAP block at rest 0 hr postoperative  1.24±1.3, 3.12±2.45 (p-value <0.001) at 2 hr 1.76±1.01, 3.68±2.44 (p-value <0.001) at 6 hr 1.32±1.37, 3.08±2.41 (p-value 0.001) and 24 hr 0.96±1.54, 1.72±1.42 (p-value 0.134) . Pain score in TAP block versus NON TAP block at movement 0 hr postoperative 2.6±1.82 (p-value 0.001) at 2 hr 3±1.15 , 4.64±2.43 (p-value 0.001) at 6 hr 2.68±1.1, 4.76±2.5  (p-value <0.001) and 24 hr 2.32±1.24, 3.04±1.45 (p-value 0.162). Number of patients were received morphine in TAP block 5 persons(20%) NON TAP block 14 persons(56%) p-value 0.009. Incidence PONV TAP block 1 patient (4%), NON TAP block 3 patients (12%) p-value 0.609.

            Conclusion : Pain score in TAP block group is less than NON TAP block group at 0,2,6 hr postoperatively but no different at 24 hr. Less Opioid consumption is shown in TAP block during intraoperative period and 24 hr postoperatively compare to NON TAP block group. There is no significant different of PONV incidence between 2 groups.

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Wanich P. Comparison of Ultrasound-guided Transversus abdominis plane block and opioid on pain for postoperative analgesia in Laparoscopic surgery in Krabi hospital : A randomized controlled trail. Kb. Med. J. [Internet]. 2023 Jan. 10 [cited 2024 Apr. 19];5(2):27-3. Available from:
Original Article


Komatsu, S. and Y. Fujiwara . Transversus abdominis plane block in laparoscopic colorectal surgery. Annals of Laparoscopic and Endoscopic surgery 2017;2:83;66-67.

Kunapaisal T., Pattaravit N., Thongsuksai P. Factors Associated with Moderate to Severe Pain after Laparoscopic Surgery. J Health Sci Med Res 2021;39(5):365-372

Mouton WG, Bessell JR, Otten KT, Maddern GJ. Pain after laparoscopy. Surg Endosc. 1999 May;13(5):445-8.

Zhao, X. and Y. Tong. Transversus abdominis plane block fot postoperative analgesia after laparoscopic surgery: a systematic review and meta-analysis. International Journal of Clinical and Experimental Medicine 2014; 7(9): 2966-2975

คงศักดิ์ เตชะวิบูลย์ผล. การฉีดยาชาเฉพาะส่วนในชั้นกล้ามเนื้อ Internal oblique และ Transversus Abdominis Plane Block: Easy procedure, Better Benefit. Thai journal of anesthesia 2014; 40(4): 307-321.

Tsai, H.-C. and T. Yoshida. Transversus abdominis plane block: An update Review of Anatomy and Techniques. BioMed Research International 2017; 7: 1-12.

Jakobsson, J. and L. Wickerts. Transversus abdominal plane (TAP) block for postoperative pain management: a review. F1000Reserch 2015; 4:F1000 Faculty Rev-1359.

Barazanchi, A. W. H. and W.S.MacFater. Evidence-based management of pain after laparoscopic cholecystectomy: a PROSPECT review update. British journal of anesthesia 2018; 121(4):787-803.

Dimitrios K. Manatakis, N. S. Transient Femoral Nerve Palsy Complicating "Blind" Transversus Abdominis Plane Block. Case Reports in Anesthesiology 2013; 2013(4):874215.

Mark J. Young, A. G. Clinical Implications of the Transversus Abdominis Plane Block in Adults. Anesthesiology Research and Practice 2012; 2012:731645.

F.W.Abdallah. Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominis incisions: a meta-analysis. British journal of anesthesia 2013; 111(5):721-35.

N. Johns, S. O. N., N.T. Ventham, F. Barron, R.R. Brady, T. Daniel. Clinical effectiveness of transversus abdominis plane (TAP) block in abdominal surhery: a systematic review and meta-analysis. The Association of coloproctology of Great Britain and Ireland 2012; 14: e635-e642.