LAPAROSCOPIC ASSISTED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK: DEVELOPMENT OF NOVEL TECHNIQUE FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING GYNAECOLOGICAL LAPAROSCOPIC SURGERIES

Abstract

Introduction: Postoperative pain after laparoscopy surgery can lead to an increased consumption of opioids, with subsequent nausea, delayed bowel function, and prolonged postoperative recovery. Laparoscopic assisted TAP block is safe, easy to perform and as it is under direct laparoscopic vision, it eliminates the risks of peritoneal perforation.

Method: 40 female patients between age 40-70 years, ASA physical status I, II and III undergoing total laparoscopic hysterectomy were divided in two groups T (TAP) and C (CONTROL) group. General anaesthesia was given with standard induction and maintenance technique. At the end of surgery, prior to extubation, in group-T laparoscopic assisted TAP block was given with inj. Bupivacaine plain (0.25%) injected bilaterally. Patients in group-C were not given TAP block. Post-operative VAS score, time until request of rescue analgesia and frequency of additional analgesia in first 24hr was noted.

Result: In terms of postoperative analgesia and additional analgesic requirement, group T (Tap) was better as compared to group-C (Control).

Conclusion: Laparoscopic guided TAP block is simple, safe and most effective supplemental techniques as part of the multimodal post-operative analgesic regimen in patients undergoing gynaecological laparoscopy surgery with lower visceral injury risk.