TPTh 9.16 Transversus Abdominis Plane Block Versus Subcutaneous Infiltration with Local Anaesthetic in Laparoscopic Cholecystectomy

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ID: 323882
2026
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Abstract
Abstract Aims Transversus Abdominis Plane (TAP) block is a well-established regional anaesthesia technique for postoperative pain control after abdominal surgery. Ultrasound-guided TAP blocks effectively reduce pain after laparoscopic cholecystectomy. Laparoscopic-assisted TAP block, performed under direct surgical vision, provides an alternative without ultrasound. This study compared the postoperative analgesic efficacy of laparoscopic-assisted TAP block versus subcutaneous infiltration at port sites in laparoscopic cholecystectomy patients, including effects on mobility and quality of life. Methods This prospective, non-randomised, patient-blinded controlled study enrolled adult patients (≥16 years) undergoing elective laparoscopic cholecystectomy at Southend University Hospital. Exclusions included refusal of consent, chronic pain medication use, or relevant drug allergies. Patients received either laparoscopic-assisted TAP block (40 ml 0.25% levobupivacaine) without wound infiltration (intervention group) or subcutaneous local infiltration (SCI) at port sites (same dose/agent) without TAP block (control group). Results Twenty-five patients were included per group (total 50). Median age was 52.5 years, BMI 30 kg/m²; 13 males, 37 females. The SCI group was older (mean 58.2 vs. 48.2 years; p=0.036). No significant differences existed in gender, BMI, operative difficulty (Nasser score), mobility at 4/24 hours, or quality of life (poor/fair/good/excellent). Pain scores showed no differences at 4 hours (rest: 5.12 vs. 5.48, p=0.537; cough: 5.96 vs. 6.88, p=0.084) or 24 hours (rest: 4.68 vs. 4.64, p=0.944; cough: 5.56 vs. 6.60, p=0.068) between TAP and SCI groups. Conclusions Laparoscopic-assisted TAP block and local skin infiltration offered equivalent postoperative analgesia, mobility, and quality of life after laparoscopic cholecystectomy, with no significant differences.
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Authors Abraham Ayantunde, Andrew Chiagozie Ekwesianya, Himadry Sarker, Abraham Jesudoss
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.530
URL
https://doi.org/10.1093/bjs/znag087.530
Keywords Keywords not found

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