• Jaime Ortiz, James W Suliburk, Kenneth Wu, Neil S Bailard, Chawla Mason, Charles G Minard, and Raja R Palvadi.
• Department of Anesthesiology, Baylor College of Medicine, Houston, TX 77030, USA. jaimeo@bcm.edu
• Reg Anesth Pain Med. 2012 Mar 1;37(2):188-92.

Background And ObjectivesTransversus abdominis plane (TAP) block has been shown to reduce pain and analgesic requirements after abdominal surgery. Our hypothesis was that bilateral TAP blocks decrease pain after laparoscopic cholecystectomy when compared with local anesthetic infiltration of trocar insertion sites.MethodsEighty patients undergoing laparoscopic cholecystectomy were randomized to receive either bilateral TAP blocks or local anesthetic infiltration of trocar insertion sites with ropivacaine 0.5%. Postoperative pain scores and analgesic use for the first 24 hrs were recorded.ResultsEighty patients were enrolled in the study. After exclusions, data were analyzed on 39 patients in group T (bilateral TAP block) and 35 patients in group I (infiltration). There was no statistically significant difference in pain scores on the numeric analog scale (0-10) between the groups at 4 hrs after surgery (P = 0.18) or during the 24 hrs after surgery (P = 0.23). The time interval from anesthesia start to surgery start was greater in group T than group I (48 vs 35 mins, P < 0.001). There was no significant difference found in analgesic use during the first 24 hrs after surgery.ConclusionsBilateral ultrasound-guided TAP block is equivalent to local anesthetic infiltration of trocar insertion sites for overall postoperative pain in a heterogeneous group of patients undergoing laparoscopic cholecystectomy.

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