Subcostal TAP Block Versus Combined Subcostal TAP and Recto-Intercostal Fascial Plane Block for Analgesia After Laparoscopic Cholecystectomy

Condition(s) studied

Investigational drug(s) / intervention(s)

Subcostal TAP Block: Following induction of general anesthesia and before surgical incision, a bilateral ultrasound-guided subcostal transversus abdominis plane block will be performed. A total volume of 40 mL of 0.20% bupivacaine will be administered.

Subcostal TAP Block + Recto-Intercostal Fascial Plane Block: Following induction of general anesthesia and before surgical incision, a bilateral ultrasound-guided subcostal transversus abdominis plane block will be performed using a total volume of 40 mL of 0.20% bupivacaine. In addition, a bilateral ultrasound-guided recto-intercostal fascial plane block will be performed using a total volume of 30 mL of 0.20% bupivacaine.

Study summary

Laparoscopic cholecystectomy is commonly associated with moderate postoperative pain, particularly during the early postoperative period. Inadequate postoperative analgesia may negatively affect patient comfort and recovery, increase opioid consumption, and contribute to opioid-related adverse effects. Therefore, effective multimodal analgesic strategies are of considerable importance in patients undergoing laparoscopic cholecystectomy.

Subcostal transversus abdominis plane (TAP) block is a regional anesthesia technique used to provide analgesia for upper abdominal surgery. However, its analgesic coverage may be insufficient in some patients because of the complex innervation of the upper abdominal wall. The recto-intercostal fascial plane block has been described as a fascial plane block targeting the anterior branches of the thoracoabdominal nerves and may provide additional analgesic benefit when combined with subcostal TAP block.

This study aims to compare the postoperative analgesic efficacy of bilateral subcostal TAP block alone with that of bilateral subcostal TAP block combined with recto-intercostal fascial plane block in patients undergoing elective laparoscopic cholecystectomy.

Eligibility

Primary outcome measure(s)

• Pain Score — On the operation day
  Pain will be assessed at rest using the visual analog scale on a scale from 0 (no pain) to 100 (worst pain). Pain assessment will be done at 6th hour after surgery.

Trial sites (1)

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