الفهرس 
Laparoscopic cholecystectomyOnly 14 pages are availabe for public view
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Abstract
Laparoscopic cholecystectomy is the mainstay treatment of benign
biliary disease. Pain continues to be an important issue after laparoscopic
cholecystectomy resulting in prolonged admissions or readmissions. With
significant variations in analgesic protocols a unified approach is necessary
to provide standardized interventions to reduce pain.
Sufficient postoperative medication is correlated with beneficial
long-term outcomes for patients like decreased postoperative cognitive
changes, enhanced way of life and decreased risk of chronic or persistent
postoperative pain, but it is a double edged sword as abundance of
analgesic use, carry the risk of more side effects particularly, emesis,
respiratory distress and anesthesia that may result in longer stay in the
hospital and therapy that decreases the benefits of fast-track operation.
There are various modalities available for postoperative pain relief
ranging from parenteral analgesia (NSAIDS and opioids), epidural
analgesia, peripheral nerve blocks, incisional infiltration and intraperitoneal
instillation using local anesthetics. Prevention of transmission of nerve
signals from the trauma site to the spinal cord and reduction of neurogenic
local inflammation at the trauma site has been reported with the use of local
anesthetics.
Therapy for postoperative pain following abdominal surgery is
focused on traditional medicines which consist of paracetamol, NSAID and
oral or intravenous opioids. These drugs are correlated with negative
outcomes such as hypotension sedation, nausea, and elevated heart load.
All negative impacts delay the early discharge and recovery. The function
of subcostal transverse abdominal block with local anesthetic and adjuvant
can also be added to this for postoperative pain relief.
Lately, ultrasound-guided oblique subcostal transverse abdominal
plane block techniques have been widely utilized to prevent blind
procedure complications and to provide better control of a range of
postoperative pain following laparoscopic cholecystectomy. Currently it is
used more often as a substitute in upper abdominal surgeries.
The aim of the current study was to compare the effect of preoperative oblique subcostal TAP and lateral TAP blocks on the total
perioperative opioids consumption for patients undergoing elective
laparoscopic cholecystectomy.