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Comparison between peripheral nerve stimulator-guided serratus anterior plane block versus transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy under general anaesthesia: A double-blind randomised controlled trial. | LitMetric

AI Article Synopsis

  • This study compares two techniques for postoperative pain relief after laparoscopic cholecystectomy: a serratus anterior plane block (SAP) and a transversus abdominis plane block (TAP), using peripheral nerve stimulation (PNS) for guidance.
  • Results showed that the TAP block resulted in lower pain scores and delayed the need for rescue analgesics compared to the SAP block, with patients in the TAP group using less tramadol for pain management in the first 24 hours post-surgery.
  • The conclusion emphasizes that the TAP block provides more effective pain control with fewer complications compared to the SAP block, making it a preferable option for postoperative analgesia.

Article Abstract

Background And Aims: Laparoscopic cholecystectomy (LC) is a widely accepted surgical procedure associated with postoperative pain. This study was done to compare peripheral nerve stimulator (PNS)-guided serratus anterior plane block (SAP) and transversus abdominis plane (TAP) block for postoperative analgesia for patients undergoing LC.

Methods: Following approval from the ethical committee, 70 patients for LC were randomly assigned to Group S: SAP block and Group T: TAP block. The blocks were performed under PNS guidance, and 20 ml of 0.375% ropivacaine was administered. The severity of pain was measured using a visual analogue scale (VAS). The study's primary objective was the evaluation of the postoperative VAS score. The time of the first dose of rescue analgesia and total tramadol consumption for 24 h postoperatively were secondary objectives. All the statistical calculation was done using statistical analyses for Social Sciences for Windows version 23.0 (IBM Corp, NY, USA).

Results: Lower VAS score was seen in patients of TAP block at rest as well as movement at 6 h ( = 0.001), 12 h ( = 0.001) and 18 h ( = 0.001) postoperatively compared with SAP. The TAP group showed a significantly increased time of first rescue analgesic compared to the SAP group (7.97 ± 0.51 vs. 5.89 ± 1.45, = 0.001). Tramadol usage was significantly higher in the SAP group than in the TAP group (128.9 ± 36.22 vs. 72.43 ± 44.80, = 0.001).

Conclusion: TAP block guided by the PNS improves postoperative pain with less tramadol consumption and during the postoperative period without significant complications.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488576PMC
http://dx.doi.org/10.4103/ija.ija_205_23DOI Listing

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