Postoperative Analgesia after Laparoscopic Cholecystectomy - Prospective, Randomized, Double Blind, Control Trial

Area of Science:

• Anesthesiology
• Surgical Pain Management
• Regional Anesthesia

Background:

• Laparoscopic cholecystectomy is a common surgical procedure.
• Effective postoperative pain management is crucial for patient recovery.
• Current analgesic techniques, including opioid analgesia and local anesthetic infiltration, have limitations.

Purpose of the Study:

• To compare the efficacy of three analgesic techniques following laparoscopic cholecystectomy.
• To determine the most efficient pain management strategy.
• To evaluate pain scores and opioid consumption.

Main Methods:

• Prospective, randomized, double-blind, controlled trial.
• 81 patients randomized into three groups: IV opioid analgesia, oblique subcostal Transversus Abdominis Plane (OSTAP) block, and local anesthetic infiltration (LAI).
• Primary outcome: Visual Analog Scale (VAS) pain scores; Secondary outcomes: intraoperative and 24-hour opioid consumption.

Main Results:

• The OSTAP block group demonstrated significantly lower VAS pain scores at all measured time points in the first 24 hours compared to both IV opioid and LAI groups (p < 0.001).
• Intraoperative fentanyl and 24-hour pethidine consumption were significantly reduced in the OSTAP block group versus the other two groups (p < 0.001).
• 75 patients were analyzed.

Conclusions:

• The OSTAP block is a more effective analgesic technique than traditional IV opioid analgesia and local anesthetic infiltration for laparoscopic cholecystectomy.
• OSTAP block offers improved pain control and reduced opioid requirements.
• This finding supports the wider adoption of OSTAP block in clinical practice.