RESUMEN
PURPOSE: To compare the analgesic efficacy of unilateral subcostal transversus abdominis plane (TAP) block with local anesthetic infiltration, applied to the port site in patients undergoing laparoscopic cholecystectomy (LC). METHODS: Group T received a unilateral subcostal TAP block, group I received a local anesthetic infiltration at port sites, and group C was the control group. Groups T and I received 20â¯mL 0.25% bupivacaine. Intravenous patient-controlled analgesia with tramadol was similarly applied to all groups. Postoperative pain levels during rest and cough were evaluated using a numeric rating scale (NRS). Nausea and vomiting were evaluated using postoperative nausea vomiting scores (PONV) at 1, 3, 6, 12 and 24â¯h and tramadol consumption was also determined. Patient satisfaction was evaluated using a Likert-type scale. RESULTS: Postoperative resting NRS scores were lower in group T than the other groups at 1 h and 12 h (pâ¯= 0.007 and pâ¯= 0.016), while NRS values during cough were statistically significant at 1 h (pâ¯= 0.004). The 24h tramadol consumption was different: group T 229⯱ 33â¯mg, group I 335⯱ 95â¯mg, and group C 358⯱ 66â¯mg (pâ¯< 0.001). The percentages of patients reporting that they would prefer the applied postoperative pain control method again were 83.3%, 62.5% and 70.8% in groups T, I and C, respectively (pâ¯= 0.118). CONCLUSION: Unilateral subcostal TAP block was superior to local anesthetic infiltration at port sites after LC, in terms of low opioid consumption. Unilateral subcostal TAP block is recommended as part of a multimodal analgesic protocol.