الفهرس | Only 14 pages are availabe for public view |
Abstract Laparoscopic cholecystectomy is the mainstay treatment of benign biliary disease. Pain continues to be an important issue after laparoscopic cholecystectomy resulting in prolonged admissions or readmissions. With significant variations in analgesic protocols a unified approach is necessary to provide standardized interventions to reduce pain. Sufficient postoperative medication is correlated with beneficial long-term outcomes for patients like decreased postoperative cognitive changes, enhanced way of life and decreased risk of chronic or persistent postoperative pain, but it is a double edged sword as abundance of analgesic use, carry the risk of more side effects particularly, emesis, respiratory distress and anesthesia that may result in longer stay in the hospital and therapy that decreases the benefits of fast-track operation. There are various modalities available for postoperative pain relief ranging from parenteral analgesia (NSAIDS and opioids), epidural analgesia, peripheral nerve blocks, incisional infiltration and intraperitoneal instillation using local anesthetics. Prevention of transmission of nerve signals from the trauma site to the spinal cord and reduction of neurogenic local inflammation at the trauma site has been reported with the use of local anesthetics. Therapy for postoperative pain following abdominal surgery is focused on traditional medicines which consist of paracetamol, NSAID and oral or intravenous opioids. These drugs are correlated with negative outcomes such as hypotension sedation, nausea, and elevated heart load. All negative impacts delay the early discharge and recovery. The function of subcostal transverse abdominal block with local anesthetic and adjuvant can also be added to this for postoperative pain relief. Lately, ultrasound-guided oblique subcostal transverse abdominal plane block techniques have been widely utilized to prevent blind procedure complications and to provide better control of a range of postoperative pain following laparoscopic cholecystectomy. Currently it is used more often as a substitute in upper abdominal surgeries. The aim of the current study was to compare the effect of preoperative oblique subcostal TAP and lateral TAP blocks on the total perioperative opioids consumption for patients undergoing elective laparoscopic cholecystectomy. |