Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot Study

Laparoscopic cholecystectomy (LC) is the gold standard of treatments for symptomatic gallstone disease. The aim of this study is to determine if postoperative opiate use is reduced with transversus abdominus plane (TAP) and rectus sheath (RS) regional anaesthetic blocks compared to port site local a...

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Main Authors: Sara Izwan, Tanishk Malhotra, Ujvala Vemuru, Michelle Cooper
Format: Article
Language:English
Published: MDPI AG 2024-07-01
Series:Surgeries
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Online Access:https://www.mdpi.com/2673-4095/5/3/44
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author Sara Izwan
Tanishk Malhotra
Ujvala Vemuru
Michelle Cooper
author_facet Sara Izwan
Tanishk Malhotra
Ujvala Vemuru
Michelle Cooper
author_sort Sara Izwan
collection DOAJ
description Laparoscopic cholecystectomy (LC) is the gold standard of treatments for symptomatic gallstone disease. The aim of this study is to determine if postoperative opiate use is reduced with transversus abdominus plane (TAP) and rectus sheath (RS) regional anaesthetic blocks compared to port site local anaesthetic (LA) infiltration. A prospective, randomised cohort study was conducted of adult patients who underwent an emergency LC between 25 April 2022 and 25 May 2023. An amount of 40 mL of 0.375% ropivacaine was infiltrated as either TAP and RS blocks or to port sites. Patient demographics, operative data, and postoperative opioid use were collected from the medical record. In total, 138 patients were enrolled in this study: 73 patients allocated to the LA to port sites cohort (52.9%) and 65 patients in the TAP and RS cohort (43.5%). The most common indication for surgery was acute cholecystitis. The average amount of opiate analgesia use was 115.2 mg in the LA group compared to 61.2 mg in the TAP and RS group (<i>p</i> < 0.05). Optimisation of postoperative pain allows for early recovery, improved patient satisfaction, and improved cost-effectiveness for the health service. With a trend towards multimodal analgesia, the uptake of TAP and RS regional anaesthesia may help to achieve this goal.
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spelling doaj-art-1da794359fc248479cdff09059f43a5a2025-08-20T01:55:52ZengMDPI AGSurgeries2673-40952024-07-015354955910.3390/surgeries5030044Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot StudySara Izwan0Tanishk Malhotra1Ujvala Vemuru2Michelle Cooper3Department of General Surgery, Gold Coast University Hospital, Southport 4215, AustraliaDepartment of General Surgery, Gold Coast University Hospital, Southport 4215, AustraliaDepartment of General Surgery, Gold Coast University Hospital, Southport 4215, AustraliaDepartment of General Surgery, Gold Coast University Hospital, Southport 4215, AustraliaLaparoscopic cholecystectomy (LC) is the gold standard of treatments for symptomatic gallstone disease. The aim of this study is to determine if postoperative opiate use is reduced with transversus abdominus plane (TAP) and rectus sheath (RS) regional anaesthetic blocks compared to port site local anaesthetic (LA) infiltration. A prospective, randomised cohort study was conducted of adult patients who underwent an emergency LC between 25 April 2022 and 25 May 2023. An amount of 40 mL of 0.375% ropivacaine was infiltrated as either TAP and RS blocks or to port sites. Patient demographics, operative data, and postoperative opioid use were collected from the medical record. In total, 138 patients were enrolled in this study: 73 patients allocated to the LA to port sites cohort (52.9%) and 65 patients in the TAP and RS cohort (43.5%). The most common indication for surgery was acute cholecystitis. The average amount of opiate analgesia use was 115.2 mg in the LA group compared to 61.2 mg in the TAP and RS group (<i>p</i> < 0.05). Optimisation of postoperative pain allows for early recovery, improved patient satisfaction, and improved cost-effectiveness for the health service. With a trend towards multimodal analgesia, the uptake of TAP and RS regional anaesthesia may help to achieve this goal.https://www.mdpi.com/2673-4095/5/3/44laparoscopic cholecystectomyregional anaesthesiageneral surgery
spellingShingle Sara Izwan
Tanishk Malhotra
Ujvala Vemuru
Michelle Cooper
Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot Study
Surgeries
laparoscopic cholecystectomy
regional anaesthesia
general surgery
title Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot Study
title_full Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot Study
title_fullStr Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot Study
title_full_unstemmed Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot Study
title_short Transversus Abdominis Plane with Rectus Sheath Blocks Versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy—Does It Reduce Postoperative Opiate Requirement? A Pilot Study
title_sort transversus abdominis plane with rectus sheath blocks versus port site infiltration of local anaesthesia in emergency laparoscopic cholecystectomy does it reduce postoperative opiate requirement a pilot study
topic laparoscopic cholecystectomy
regional anaesthesia
general surgery
url https://www.mdpi.com/2673-4095/5/3/44
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AT ujvalavemuru transversusabdominisplanewithrectussheathblocksversusportsiteinfiltrationoflocalanaesthesiainemergencylaparoscopiccholecystectomydoesitreducepostoperativeopiaterequirementapilotstudy
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