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TAP BLOCK IN CHRONIC POSTSURGICAL PAIN MANAGEMENT AFTER LAPAROSCOPIC CHOLECYSTECTOMY
ESRA Academy. Sayhan H. Sep 8, 2016; 138486; 0345 Topic: Chronic Pain Management
Dr. Havva Sayhan
Dr. Havva Sayhan

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Abstract
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Background and Aims:

The transversus abdominis plane (TAP) block provides analgesia to the nerves supplying the anterior abdominal wall from T6 to L1 that innervate the parietal peritoneum, skin and muscles. The TAP block is effective in providing postoperative analgesia after abdominal surgery. This study reported the use of TAP block in chronic postsurgical pain management (CPSP) in two patients who had laparoscopic cholecystectomy.

Methods:

The patients had been suffering from pain after laparoscopic cholecystectomy for two years and one and half years with Visual analog pain scores (VAS) of 6 and 7 respectively. A ultrasound (USG)-guided TAP block was performed unilaterally with 0.25% bupivacaine 16 mL and 1500 international unit of hyaluronidase. VAS scores were recorded at 15 min, 1, 3, and 6 months postoperatively to assess pain severity.  

Results:

The VAS pain scores were significantly reduced in the TAP block as 0 and 1-2/10 at 15 min in both patients respectively. The TAP block was repeated on the first patient after 1 month follow up as a result of experienced pain with a VAS score of 2/10.  The evaluated chronic postsurgical pain  at 3 and 6 months was minimal with a VAS of 0 in both of patients, and long-term benefit from TAP block has been demonstrated. No complications were noted related to TAP blockade.

Conclusions:

As a result, we have experienced that the USG guided TAP block is a safe and efficient alternative technique for pain management of CPSP in patients who had laparoscopic cholecystectomy.

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