Pain control in laparoscopic surgery: a case–control study between transversus abdominis plane-block and trocar-site anesthesia

Local anesthesia in laparoscopic operations is gaining increasing consensus. To standardize analgesia, a prospective case–control study was created over a 1-year period, in collaboration with the anesthesiology service in our community hospital. Starting from February 2016, we prospectively enrolled...

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Bibliographic Details
Published in:Updates in surgery 2019-12, Vol.71 (4), p.717-722
Main Authors: Molfino, Sarah, Botteri, Emanuele, Baggi, Paolo, Totaro, Luigi, Huscher, Michela, Baiocchi, Gian Luca, Portolani, Nazario, Vettoretto, Nereo
Format: Article
Language:English
Subjects:
Abdominal Muscles - innervation
Adolescent
Adult
Aged
Aged, 80 and over
Anesthetics, Local - administration & dosage
Appendectomy - adverse effects
Case-Control Studies
Cholecystectomy, Laparoscopic - adverse effects
Elective Surgical Procedures - adverse effects
Female
Humans
Laparoscopy - adverse effects
Male
Medicine
Medicine & Public Health
Middle Aged
Nerve Block - methods
Original Article
Pain, Postoperative - prevention & control
Surgery
Young Adult
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Summary:Local anesthesia in laparoscopic operations is gaining increasing consensus. To standardize analgesia, a prospective case–control study was created over a 1-year period, in collaboration with the anesthesiology service in our community hospital. Starting from February 2016, we prospectively enrolled adult patients (more than 16 years old) undergoing laparoscopic appendectomy or cholecystectomy, either in emergency or elective setting. Patients were preoperatively assigned (based on the chart-admission number) either to transversus abdominis plane (TAP) block treatment (Group 1—experimental arm) or trocar-site anesthesia (TSA) (Group 2—experimental arm), and then compared with group of patients not submitted to treatment (Group 3—control arm). Demographic and clinical characteristics of each patient were recorded. Post-operative pain level (primary outcome) was assessed with visual analog scale (VAS) score; analgesic use and length of stay in hospital were defined as secondary outcomes. Forty-two patients were assigned to TAP block treatment (Group 1), fifty-two to TSA (Group 2), and thirty-nine underwent no pre-incisional treatment (Group 3). In the comparison between patients undergoing TAP block or TSA with the control arm, a significance difference in reported pain was recorded in every scheduled time ( p  
ISSN:2038-131X
2038-3312
DOI:10.1007/s13304-018-00615-y