EFFICACY OF ULTRASOUND GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POST OPERATIVE ANALGESIA IN LAPAROSCOPIC CHOLECYSTECTOMY: COMPARISON OF TWO DIFFERENT CONCENTRATION AND VOLUME OF BUPIVACAINE

Abstract

Laparoscopic Cholecystectomy is one of the most common surgical procedure considered as the gold standard for the treatment of symptomatic gallbladder disease.Pain at the port sites is due to stretching by pneumoperitoneum and hepatic bed disturbances.Different techniques are in practice for postoperative analgesia. Now a days, Transversus Abdominis Plane (TAP) block is commonly performed truncal neural block owing to its high success rate, feasibility, safety and its ability to provide prolonged postoperative pain relief. In this block, local anaesthetic is inltrated between the internal oblique and transversus abdominis muscle which blocks ventral rami of lower six thoracic and upper lumbar nerves (T7 to L1) especially subcostal (T12), ilioinguinal (L1) and iliohypogastric(L1). The study was designed to evaluate the efcacy and safety of USG guided Right sided Subcostal TAP block using two different concentration and volume of Bupivacaine and their efcacy to produce postoperative analgesia in patients undergoing laparoscopic cholecystectomy.Larger volume with lower concentration of Bupivacaine (0.16%) 30 ml provides better analgesia, longer duration of effective analgesia, better hemodynamic stability and requires less analgesic consumption in postoperative period.