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

Abstract

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.