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Comparison of analgesic efficacy of oblique subcostal and lateral transversus abdominis plane block after laparoscopic cholecystectomy
Med Biol Sci Eng 2018;1(1):23-30
Published online January 31, 2018
© 2018 Medical Biological Science and Engineering.

Keum Young So1,2, In Gook Jee1, Ki Tae Jung1,2, Sang Hun Kim1,2

1Department of Anesthesiology and Pain Medicine, Chosun University Hospital, 2Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, Gwangju, Korea
Correspondence to: Sang Hun Kim
Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, 309 Pilmundaero, Dong-gu, Gwangju 61452, Korea
Tel: +82-62-220-3223
Fax: +82-62-223-2333
E-mail: ksh3223@chosun.ac.kr
Received October 27, 2017; Revised November 23, 2017; Accepted December 1, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
This prospective, double-blinded, randomized, controlled study was undertaken to compare the additional postoperative analgesic effects of oblique subcostal and lateral transversus abdominis plane blocks using visual analog scale (VAS) scores and algometry determined pressure pain thresholds (PPTs), and to investigate the correlation between VAS scores and PPTs in patients on patient-controlled analgesia (PCA) after laparoscopic cholecystectomy. Sixty patients aged 20 to 65 years, ASA physical status I or II, were randomly allocated to one of three groups: a group not administered a TAP block (TAPC group, n=20), a group that received an oblique subcostal TAP block (TAPS group, n=20), and a group that received a lateral TAP block (TAPL group, n=20). Bilateral TAP blocks were performed after skin closure. All patients subsequently received fentanyl (20 µg/kg) PCA. At 8 hours postoperatively, VAS scores during coughing was negatively correlated with PPTs on right skin incision site (r=-0.418, p=0.001). We conclude oblique subcostal and lateral TAP blocks have no additional postoperative analgesic effect in patients on PCA after laparoscopic cholecystectomy, and suggest that algometer determined PPTs offer a potential objective alternative to VAS scores for assessing postoperative pain.
Keywords : Cholecystectomy, laparoscopic; Pain, postoperative; Pressure pain threshold; Transversus abdominis plane block; Visual analog scale
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