Efficacy of preperitoneal local anesthetic infiltration on post-operative analgesia following laparoscopic cholecystectomy
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Introduction: Post-operative pain significantly impairs recovery, delaying hospital discharge after laparoscopic cholecystectomy. Effective pain management facilitates early ambulation, which diminishes the probability of post-operative complications. Objective: This study compares the analgesic efficacy of preperitoneal bupivacaine infiltration with dexamethasone and the transversus abdominis plane (TAP) block. Methods: This prospective, randomized, double-blinded study included 40 patients undergoing laparoscopic cholecystectomy. Group 1 (n = 20) received a TAP block, while Group 2 (n = 20) received preperitoneal bupivacaine for analgesia. The primary outcomes were (i) the level of post-operative pain, assessed using the Visual Analog Scale every 15 min in the 1st post-operative hour, at 2-h intervals up to 12 h, and at 6-h intervals up to 24 h; (ii) time to first request for rescue analgesia; and (iii) the total dose of analgesia. Secondary outcomes included patient-reported sleep quality and the incidence of post-operative nausea and vomiting. Results: The study found that the TAP block provided superior post-operative pain relief compared to preperitoneal infiltration with bupivacaine in patients who underwent laparoscopic cholecystectomy. The TAP block group exhibited significantly lower pain scores at 8 and 12 h postoperatively and experienced a delayed first request for rescue analgesia at 14.6 ± 2.52 h on average, compared with 7.1 ± 1.02 h in the preperitoneal group. Conclusion: The findings establish that TAP block is a more effective analgesic technique than preperitoneal infiltration with bupivacaine for managing post-operative pain in laparoscopic cholecystectomy. Patients receiving TAP block required fewer opioids, had delayed onset of rescue analgesia, and reported lower pain scores at critical post-operative intervals.
Authors: Noha Mohamed Abdelwahab Elsaid, Ain El-Marwa Abdelmonem Abdallah Hassan, Ahmed Mohamed Said, Mostafa R. Bakry, Doaa Mohamed Almonayery Ibrahim, Marwa Ibrahim Eid, Hayam Shaaban Soliman Morsy, Mostafa Mohamed Elsayed, Nashwa Mohammed Ibrahiem, Gihan Eissa Zahran, Nahla Mohammed Eldeeb, Mayada Yahia Elbohouty, Heba Atwa Ahmed Atwa, Gehan Abd Elrhman Eldesoky, Eman A. Salem, Samia Sayed Ahmed, Warda Demerdash Khalifa Ali, Tarek Abdelmonem Abdelzaher
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414480973
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