Interfascial blocks of the abdominal wall for perioperative analgesia during laparoscopic cholecystectomy

Objective. To compare the effect of laparoscopically controlled TAP–block and TAP–block under ultrasound navigation during laparoscopic cholecystectomy on pain relief, hemodynamics, and recovery rate of patients. Materials and methods. Laparoscopic cholecystectomy was performed in 40 patients, who were divided into two groups of 20 patients in each group. In group 1, after induction and intubation, a TAP–block was performed under ultrasound navigation. In group 2, after induction and intubation, the first optical port was placed using a laparoscopically controlled TAP–block. The demographic (age, gender) and clinical (body mass index, comorbidity, ASA functional class) parameters of the patient groups were comparable. The duration of the blockade was recorded in both groups. Hemodynamics was monitored intraoperatively. Patients assessed the level of pain using a visual analog scale at 0, 2, 4, 8 hours after surgery. Results. The duration of the blockade was shorter in group 2 (1.7 minutes) than in group 1 (3.8 minutes). Intraoperatively studied hemodynamic parameters in both groups did not have statistically significant deviations. Patients in group 1 required less narcotic analgesics intraoperatively and reported less intense pain in the first hours after surgery. In both groups, there was no need for opioid analgesics in the postoperative period. Conclusions. Laparoscopically controlled TAP–block is no less effective for perioperative analgesia than TAP–block under ultrasound navigation. In addition, the laparoscopically controlled TAP–block technique is faster than the ultrasound–guided TAP–block and does not require additional logistics.