HOW TO MANAGE POST-OPERATIVE PAIN AFTER LAPAROSCOPIC CHOLESYSTECTOMY? COMPARISON OF THREE DISTINCT APPROACHES: A PROSPECTIVE RANDOMIZED CONTROLLED STUDY

Authors : Zafer Şenol, Tuna Ertürk, Taygun Gülşen, Muhammed Kadir Yıldırak, Dilek Metin Yamaç, Nurhilal Kızıltoprak, Mahmut Salih Genç, Bora İşçeviren, Sümeyra Emine Bölük, Merve Karadağ, Elif Didem Terzi, Bülent Güleç
Pages : 12-18
Doi:10.54270/atljm.2025.77
View : 121 | Download : 662
Publication Date : 2025-02-04
Article Type : Research Paper
Abstract :Aim: Laparoscopic Cholecystectomy (LC) is one of the most performed surgeries in daily general surgery practice and inadequate pain relief following surgery is associated with prolonged hospital stay. Transverse abdominis plane block (TAPB), port site local anesthetic injection (PSLAI) and gallbladder bed local anesthetic spraying (GBLAS) account for a part of numerous pain management strategies. In this study, we aimed to compare post-operative pain after laparoscopic cholecystectomy in transverse abdominis plane block (TAPB), port site local anesthetic injection (PSLAI) and gallbladder bed local anesthetic spraying (GBLAS) approaches. Materials and Methods: 99 patients were randomized into 3 groups. Patient-Controlled Analgesia (PCA) was utilized, and total analgesic demand and dosage were recorded along with Numerical Rating Scale (NRS) values at post-operative (p.o) 2, 6, 12 and 24 hours. Results: At p.o 24 hours, there was no statistically significant difference between groups in terms of PCA readings. However, NRS values were significantly higher in PSLAI group compared to TAPB and GBLAS groups. Conclusion: This study is unique as it compares the three methods in a single trial. While GBLAS gains slightly more attention as it is associated with a shorter procedure, all three methods are viable and might even be combined. We believe this study will pave way for future randomized controlled trials (RCT) in this regard.
Keywords : Laparoskopik kolesistektomi, Transvers abdominis düzlem bloğu, Port bölgesi lokal anestezik enjeksiyonu, Safra kesesi yatağı lokal anestezik püskürtme, Ağrı yönetimi

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