Abstract

Laparoscopic cholecystectomy (LC) being the minimal invasive procedure has replaced open surgery over the time. However discomfort after LC due to pain is a vital issue. So in our study we have compared efficacy of ultrasound (US) guided dual transversus abdominis plane (TAP) block with intraperitoneal instillation and periportal infiltration of local anathesia (LA) after LC. Material and methods- 100 patients planned for LC at Government medical college (GMC) Kathua, Jammu and Kashmir (J&K) were enrolled in the study and were randomly divided into two groups each having 50 patients. Group-I received US guided dual TAP block and group-II received “intraperitoneal instillation and periportal infiltration” of roipivavcaine with dexamethasone. To compare the pain experienced by both the groups, VAS visual analogue scale score (VAS) was assessed and patient satisfaction with pain control was assessed using “Global Satisfaction Score”(GSS). “P-value ≤0.05 was considered significant”. Result- First request for rescue analgesia by group-II was significantly late than group I and significantly lower number of patients in group-II required second dose of rescue analgesia. VAS score was reported to be significantly lesser by group-II compared to group-I at 1,2,4,8 & 10hr. GSS also indicated group-II patients to be more satisfied with pain control. Conclusion- Our study suggests combined “intraperitoneal instillation and periportal infiltration” to be a promising approach for postoperative analgesia after LC as patients experienced less pain, late demand for first rescue analgesia, required less postoperative analgesia and showed more satisfaction with pain control

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