Analyzing the Impact of Transvers Abdominis Plane Block, PLR, NLR on Platelet Functions, Postoperative Pain, Analgesic Consumption and Nausea-Vomiting in the Patients who Received Laparoscopic Cholecystectomy

Abstract Background: The transversus abdominis plane (TAP) block is widely utilized for postoperative analgesia following laparoscopic cholecystectomy. The posterior approach, in particular, has been shown to provide effective analgesia due to its superior distribution of local anesthetic within the plane. Aim: This study aimed to compare analgesic consumption, pain scores, nausea and vomiting scores, and hemogram parameters between laparoscopic cholecystectomy patients who received bilateral TAP block and those who did not receive the block and were managed with conventional analgesics. Methods: This retrospective study analyzed the medical records of 109 patients who underwent laparoscopic cholecystectomy. Patients were categorized into three groups based on whether they received a TAP block or not. Demographic data, pain scores (using the Visual Analog Scale, VAS), nausea and vomiting scores, analgesic consumption, and the administration of antiemetics were evaluated. Results: The study demonstrated that the 6th and 12th hour VAS scores were significantly lower in the TAP-2 group compared to the control group (p < 0.05). Additionally, the 24-hour VAS scores in the TAP-2 group were significantly lower than those in the TAP-1 group (p < 0.05). Nausea and vomiting scores at 8 and 12 hours were significantly higher in the Control group compared to the TAP-2 group (p = 0.002 and p = 0.045, respectively). Analgesic requirements at the 8th hour were significantly higher in the Control group, where no block was administered, compared to the TAP-2 group (p < 0.05). No significant correlation was observed between platelet (Plt), procalcitonin (PCT), mean platelet volume (MPV), platelet distribution width (PDW), platelet-to-lymphocyte ratio (Plt/Lymp), neutrophil-to-lymphocyte ratio (Neut/Lymp), and postoperative pain scores or analgesic requirements in the TAP-1, TAP-2, and Control groups (ρ < 0.400, p > 0.05). Conclusions: Patients who underwent bilateral TAP block exhibited significantly lower analgesic consumption and pain scores during the first 8 hours postoperatively compared to those who did not receive the block. Additionally, postoperative nausea and vomiting scores were significantly reduced in patients who received the TAP block. These findings suggest that the TAP block is an effective adjunct for enhancing postoperative pain management and reducing opioid-related side effects in laparoscopic cholecystectomy patients.