Background and Objectives: Local anaesthetics administered intraperitoneally (IP) are thought to be a good way to manage the visceral component of pain. After a laparoscopic cholecystectomy, this approach cannot be utilised as the sole pain reliever (LC). TAP (Transversus Abdominis Plane Block) is an effective anaesthetic method for treating postoperative pain following LC surgery. The researchers wanted to see how well IP bupivacaine–Magnesium Sulfate (MgSO4) and TAP by bupivacaine–Magnesium Sulfate (MgSO4) worked for pain alleviation following LC.
Materials and Methods: In this randomised double-blind trial, sixty patients with ASA I and II, ranging in age from 18 to 60 years old, who were undergoing elective LC surgery were divided into two equal groups (30 patients in each group). Group I: 30 mL IP instillation [15 mL 0.5 percent (75 mg) bupivacaine + 2.5 mL MgSO4 (250 mg) plus 12.5 normal saline]. Group II: A total amount of 20 ml was used on each side for an ultrasound guided subcostal TAP block [10 ml bupivacaine percent 0.5 (50 mg) with 1.5 ml MgSO4 (150 mg) and 8.5 normal saline]. Heart rate (HR) and mean arterial blood pressure (MAP) were measured 5 minutes before induction and every 15 minutes thereafter until the end of the operation, and then every 5 minutes for the first 20 minutes after administration of study drugs, and then every 30 minutes, 1 hour, 2 hours, 4 hours, and 6 hours postoperatively. At emergence, 2, 4, 8, 12, 18, and 24 hours following recovery, the first rescue analgesia time, postoperative analgesic use, length of hospital stay (LOS), patient satisfaction, and surgical complications were all documented using the Numeric Rating Scale (NRS).
The variations in HR and MAP between the two groups were negligible. At 4 and 8 hours, NRS in group II was significantly lower than in group I. In comparison to group I, time to first rescue analgesia, total postoperative analgesic intake, and LOS were all significantly lower in group II. When compared to group I, group II had a much higher level of satisfaction. There was no significant difference in nausea, vomiting, hypotension, bradycardia, bradypnea, or MgSO4 toxicity between the two groups.
Conclusion: In patients having LC, TAP with bupivacaine-MgSO4 provides greater analgesia, longer duration, less postoperative analgesic intake, and higher satisfaction than IP block with bupivacaine-MgSO4.
Please click here : https://journaljammr.com/index.php/JAMMR/article/view/30660
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