Analgesic Effect of Subcostal TAP Block
Condition: Subcostal TAP Block for Multiport Laparoscopic Cholecystectomy
Study type: Interventional

Summary: 
      The purpose of this study was to compare the analgesic efficacy of the ultrasound guided
      bilateral subcostal tap block with ultrasound guided bilateral posterior tap block for
      postoperative analgesia after laparoscopic cholecystectomy
    

Detailed description: 
      After approval from Ethics Review Committee, patients were enrolled according to the
      inclusion and exclusion criteria. Informed written consent for inclusion in the study was
      taken and during the process,patients were explained about the NRS and other secondary
      objectives.

      Blocks were performed under ultrasound guidance immediately after induction of anesthesia.For
      postoperative analgesia,patients were randomly allocated in two groups using draw/ballot
      method assigning patients to either of the S-TAP block group or P-TAP-block group. The
      patients and the staff providing postoperative care and the doctor assessing the pain after
      surgery were blinded to group assignment. Patients in both groups received standard of care
      analgesia during the post-operative period i.e., I/V Ketorolac 30mg every 8 hourly, I/V
      Tramadol 50mg every 8hourly and as per need basis, and I/V Paracetamol 1000mg every 6 hourly
      Subsequent surgical procedure was performed routinely. After completion of the surgery and
      emergence from anesthesia, patients were shifted to the Post Anaesthesia Care Unit, and time
      of arrival in recovery room was taken as 0-hour and noted. Assessment for outcome measures
      started in recovery room, and continued till 24 hours of the surgery.
    

Intervention name(s): Ultrasound guided bilateral subcostal TAP block; Ultrasound guided bilateral posterior TAP block
Intervention type(s): Procedure; Procedure
Intervention description(s): ultrasound guided bilateral subcostal TAP block was performed after induction of general anaesthesia.after all aseptic measures,abdomen was prepared with antiseptic spray,with the help of portable ultrasound machine using probe frequency of 11 Mega Hertz,ultrasound probe was positioned parallel to the costal margin near the midline,the rectus abdominis muscle was identified ,probe was gradually moved laterally and obliquely along the subcostal margin and the transversus abdominis muscle identified lying posterior to the rectus muscle.the 20Gauge,100millimeter long needle was introduced at the lateral edge of the rectus muscle ,from medial to lateral,in plane of the ultrasound beam.After confirmation of the plane with saline, 20ml of 0.375% solution of bupivacaine was injected on each side of the abdomen.; ultrasound guided bilateral posterior TAP block was performed after induction of general anaesthesia.after all aseptic measures,abdomen was prepared with antiseptic spray.with the help of portable ultrasound machine using probe frequency of 11Mega Hertz,ultrasound probe was positioned transversely to the abdominal wall in the midaxillary line between the iliac crest and coastal margin,and carefully moved posteriolaterally for optimal identification of plane.the 20G,100mm long needle was introduced anteriorly and in line with the probe,from medial to lateral,and advanced until it reached the fascial plane between the internal oblique and transversus abdominis muscle.upon reaching the plane ,20ml of 0.375% solution of bupivacaine was injected on each side of the abdomen.
Other intervention name(s): S-TAP Block; P-TAP Block
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Keywords: Subcostal TAP block; Posterior TAP block; Ultrasound; Laparoscopic cholecystectomy