COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY

Objective: To evaluate the analgesic efficacy of a modified ultra sound guided unilateral STAP block with 0.25% bupivacaine in laparoscopic cholecystectomy compared with conventional port site and intraperitoneal infiltration of the same drug in similar amount and concentration. Study Design: Ran...

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Autores principales:	Sarfraz Janjua, Khalid Zaeem Aslam, Saad Sarfraz, Awais Qarni, Waleed Niazi, Maria Binte Sarfraz
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2019
Materias:	cholecystectomy port-site infiltration postoperative analgesia rectus sheath block Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/c5381593a3654e95a87bc75bd56468b7
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spelling	oai:doaj.org-article:c5381593a3654e95a87bc75bd56468b72021-11-11T04:23:48ZCOMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY0030-96482411-8842https://doaj.org/article/c5381593a3654e95a87bc75bd56468b72019-08-01T00:00:00Zhttps://www.pafmj.org/index.php/PAFMJ/article/view/3203/2312https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: To evaluate the analgesic efficacy of a modified ultra sound guided unilateral STAP block with 0.25% bupivacaine in laparoscopic cholecystectomy compared with conventional port site and intraperitoneal infiltration of the same drug in similar amount and concentration. Study Design: Randomized clinical trial. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Oct 2017 to Feb 2018. Material and Methods: 100 adult female as well as male patients were randomized by lottery method into 2 equal groups. In group A (n=50) unilateral STAP block was performed under ultrasound guidance (Xario 200 Toshiba). The 18 Hz linear probe was placed in the midline of the abdomen 2 cm below the xiphisternum and moved right laterally along the subcostal margin to the anterior axillary line and bupivacaine 0.25% 0.4 ml/kg) was injected after negative aspiration test. Group B (n=50) patients received intra peritoneal instillation of 1/3 of the total drug volume before closure and conventional port site infiltration of 0.25% bupivacaine by remaining 2/3 of the total drug vol (0.4 ml/kg)by the surgeon at the end of the procedure. Results: One hundred patients were included and distributed in two equal groups. Out of 50 patients in each group six patients in group A and five patients in group B were excluded due to prolonged and difficult surgery. STAP block was associated with significantly lower postoperative mean pain scores, lesser requirement of tramadol 90.90 ± 39.28 mg vs 150.33 ± 99.3 mg and reduced recovery time 37.61 ± 6.01 vs 45.11 ± 8.75 min as compared to group B respectively. However, means of age, weight, female to male ratios, anaesthesia times, postoperative satisfaction scores and complications in both the groups did not differ significantly. Conclusion: Preoperative STAP block as a component of multimodal analgesic regimen for laparoscopic cholecystectomy provides better analgesia and leads to significantly less postoperative pain scores, consumption of analgesics and recovery time as compared to port site local anaesthetic infiltration.Sarfraz JanjuaKhalid Zaeem AslamSaad SarfrazAwais QarniWaleed NiaziMaria Binte SarfrazArmy Medical College Rawalpindiarticlecholecystectomyport-site infiltrationpostoperative analgesiarectus sheath blockMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 69, Iss 4, Pp 801-807 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	cholecystectomy port-site infiltration postoperative analgesia rectus sheath block Medicine R Medicine (General) R5-920
spellingShingle	cholecystectomy port-site infiltration postoperative analgesia rectus sheath block Medicine R Medicine (General) R5-920 Sarfraz Janjua Khalid Zaeem Aslam Saad Sarfraz Awais Qarni Waleed Niazi Maria Binte Sarfraz COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY
description	Objective: To evaluate the analgesic efficacy of a modified ultra sound guided unilateral STAP block with 0.25% bupivacaine in laparoscopic cholecystectomy compared with conventional port site and intraperitoneal infiltration of the same drug in similar amount and concentration. Study Design: Randomized clinical trial. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Oct 2017 to Feb 2018. Material and Methods: 100 adult female as well as male patients were randomized by lottery method into 2 equal groups. In group A (n=50) unilateral STAP block was performed under ultrasound guidance (Xario 200 Toshiba). The 18 Hz linear probe was placed in the midline of the abdomen 2 cm below the xiphisternum and moved right laterally along the subcostal margin to the anterior axillary line and bupivacaine 0.25% 0.4 ml/kg) was injected after negative aspiration test. Group B (n=50) patients received intra peritoneal instillation of 1/3 of the total drug volume before closure and conventional port site infiltration of 0.25% bupivacaine by remaining 2/3 of the total drug vol (0.4 ml/kg)by the surgeon at the end of the procedure. Results: One hundred patients were included and distributed in two equal groups. Out of 50 patients in each group six patients in group A and five patients in group B were excluded due to prolonged and difficult surgery. STAP block was associated with significantly lower postoperative mean pain scores, lesser requirement of tramadol 90.90 ± 39.28 mg vs 150.33 ± 99.3 mg and reduced recovery time 37.61 ± 6.01 vs 45.11 ± 8.75 min as compared to group B respectively. However, means of age, weight, female to male ratios, anaesthesia times, postoperative satisfaction scores and complications in both the groups did not differ significantly. Conclusion: Preoperative STAP block as a component of multimodal analgesic regimen for laparoscopic cholecystectomy provides better analgesia and leads to significantly less postoperative pain scores, consumption of analgesics and recovery time as compared to port site local anaesthetic infiltration.
format	article
author	Sarfraz Janjua Khalid Zaeem Aslam Saad Sarfraz Awais Qarni Waleed Niazi Maria Binte Sarfraz
author_facet	Sarfraz Janjua Khalid Zaeem Aslam Saad Sarfraz Awais Qarni Waleed Niazi Maria Binte Sarfraz
author_sort	Sarfraz Janjua
title	COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY
title_short	COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY
title_full	COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY
title_fullStr	COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY
title_full_unstemmed	COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY
title_sort	comparison of modified unilateral ultrasound guided subcostal transversus abdominis plane block with conventional port-site and intraperitoneal infiltration of bupivacaine for postoperative pain relief in laparoscopic cholecystectomy
publisher	Army Medical College Rawalpindi
publishDate	2019
url	https://doaj.org/article/c5381593a3654e95a87bc75bd56468b7
work_keys_str_mv	AT sarfrazjanjua comparisonofmodifiedunilateralultrasoundguidedsubcostaltransversusabdominisplaneblockwithconventionalportsiteandintraperitonealinfiltrationofbupivacaineforpostoperativepainreliefinlaparoscopiccholecystectomy AT khalidzaeemaslam comparisonofmodifiedunilateralultrasoundguidedsubcostaltransversusabdominisplaneblockwithconventionalportsiteandintraperitonealinfiltrationofbupivacaineforpostoperativepainreliefinlaparoscopiccholecystectomy AT saadsarfraz comparisonofmodifiedunilateralultrasoundguidedsubcostaltransversusabdominisplaneblockwithconventionalportsiteandintraperitonealinfiltrationofbupivacaineforpostoperativepainreliefinlaparoscopiccholecystectomy AT awaisqarni comparisonofmodifiedunilateralultrasoundguidedsubcostaltransversusabdominisplaneblockwithconventionalportsiteandintraperitonealinfiltrationofbupivacaineforpostoperativepainreliefinlaparoscopiccholecystectomy AT waleedniazi comparisonofmodifiedunilateralultrasoundguidedsubcostaltransversusabdominisplaneblockwithconventionalportsiteandintraperitonealinfiltrationofbupivacaineforpostoperativepainreliefinlaparoscopiccholecystectomy AT mariabintesarfraz comparisonofmodifiedunilateralultrasoundguidedsubcostaltransversusabdominisplaneblockwithconventionalportsiteandintraperitonealinfiltrationofbupivacaineforpostoperativepainreliefinlaparoscopiccholecystectomy
_version_	1718439626505453568

COMPARISON OF MODIFIED UNILATERAL ULTRASOUND GUIDED SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH CONVENTIONAL PORT-SITE AND INTRAPERITONEAL INFILTRATION OF BUPIVACAINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY

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