Ultrasound-guided subcostal-posterior transversus abdominis plane block for pain control following laparoscopic sleeve gastrectomy

Dilek E Arı, Arzu Y Ar, Ceren S Karip, Ceren Köksal, Mehmet T Aydın, Mustafa Gazi, Fatmanur Akgün, Dilek E Arı, Arzu Y Ar, Ceren S Karip, Ceren Köksal, Mehmet T Aydın, Mustafa Gazi, Fatmanur Akgün

Abstract

To investigate the analgesic effect of a subcostal-posterior transversus abdominis plane (TAP) block combination following laparoscopic sleeve gastrectomy. Methods: This study was conducted at Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey, between March 2014 and June 2015. A total of 40 patients with a body mass index of 40-60 kg/m2 scheduled for laparoscopic sleeve gastrectomy were randomly allocated into 2 groups. Patients in Group I (n=20) received a bilateral subcostal TAP block, and patients in Group II (n=20) received a bilateral subcostal and posterior TAP block. Pain intensity was assessed at rest and during coughing using the visual analog scale (VAS) prior to and at various time points after TAP block (0 min, 30 min, 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours). Morphine consumption over 24 hours and time to first morphine requirement were recorded. Results: There was no difference in VAS scores between groups. Morphine consumption was 6.78±5.95 mg in Group I, and 7.28±5.95 mg in Group II (p=0.795). Time to first morphine requirement was 267.22±303.84 min for Group I, and 207.80±209.81 min for Group II (p=0.154). Conclusions: Subcostal-posterior TAP block provided equivalent analgesia to subcostal TAP block alone following laparoscopic sleeve gastrectomy.

Figures

Figure 1
Figure 1
Comparison of VAS scores at rest between and within groups. *p<0.01 when compared with VAS score before TAP block (Wilcoxon test), &p<0.01 when compared to VAS scores at TAP block and 30 min after TAP block (Wilcoxon test)
Figure 2
Figure 2
Comparison of VAS scores during coughing between and within groups. *P &p<0.01 when compared to VAS scores at TAP block and 30 min after TAP block (Wilcoxon test).

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