Lateral Versus Subcostal TAP Block for Drain-Site Analgesia in Laparoscopic Cholecystectomy

Condition(s) studied

Investigational drug(s) / intervention(s)

Bilateral Subcostal TAP Block: Ultrasound-guided bilateral subcostal transversus abdominis plane (TAP) block performed at the end of surgery prior to extubation. A total of 40 mL of 0.25% bupivacaine (20 mL per side) will be administered.

Lateral TAP Block Plus Contralateral Subcostal TAP Block: Ultrasound-guided lateral TAP block on the side of surgical drain placement combined with a contralateral subcostal TAP block. A total of 40 mL of 0.25% bupivacaine (20 mL at each injection site) will be administered.

Study summary

Laparoscopic cholecystectomy is a commonly performed surgical procedure. Despite its minimally invasive nature, patients may experience significant postoperative pain, particularly at trocar insertion sites and surgical drain entry sites. Pain originating from the drain site is often localized to the lateral abdominal wall and may contribute substantially to postoperative discomfort.

Transversus abdominis plane (TAP) block is a regional anesthesia technique widely used for postoperative pain management after abdominal surgery. Different TAP block approaches provide analgesia to different regions of the abdominal wall.

This prospective randomized clinical trial aims to compare two TAP block strategies in patients undergoing laparoscopic cholecystectomy with surgical drain placement. Patients will be randomly assigned to receive either bilateral subcostal TAP block or a targeted approach consisting of a lateral TAP block on the drain side and a subcostal TAP block on the opposite side.

The primary outcome is postoperative drain-site pain intensity measured using the Numeric Rating Scale (NRS) at 6 hours after surgery. Secondary outcomes include pain scores at additional postoperative time points, opioid consumption, time to first analgesic request, patient satisfaction, postoperative nausea and vomiting, sedation scores, and recovery parameters.

The findings of this study may help identify a more effective regional analgesia strategy for the management of drain-site pain following laparoscopic cholecystectomy.

Eligibility

Primary outcome measure(s)

• Drain-Site Pain Score at 6 Hours Postoperatively — 6 hours after surgery
  Pain intensity at the surgical drain insertion site measured using the Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain).

Trial sites (1)