Abstract
Background and objective
Postoperative pain management is a critical aspect of patient care after surgery. It is especially important in obese patients, who have a higher risk of inadequate postoperative ventilation and chest expansion, as well as respiratory depression and obstructive sleep apnea. The usage of opioid drugs for pain management exacerbates these consequences. In these patients, opioid-free regimens incorporating regional anesthetic procedures like the transversus abdominis plane (TAP) block become indispensable. The laparoscopic-guided TAP (L-TAP) block is a new procedure that has shown promise in the treatment of postoperative pain. The main objective of the present study was to demonstrate the effectiveness and safety of TAP block for postoperative pain management under laparoscopic vision undergoing laparoscopic bariatric surgery.
Methodology
This is a randomized clinical trial including 46 patients, who were divided into two groups, 23 each, one to receive L-TAP and one as control. Postoperative pain in the first 24 h was assessed by Visual Analog Scale (VAS) scores, need for narcotic rescue analgesia, number of rescue doses required, pain scores on ambulation, and incidence of postoperative nausea and vomiting.
Results
Significantly fewer patients in the intervention group required rescue analgesia (30.4% in the intervention group to 65.2% in the control group, P=0.018). The intervention group also exhibited significantly better pain scores on ambulation (P=0.006). All other parameters showed no statistically significant difference between the two groups.
Conclusion
L-TAP is a promising technique for the alleviation of postoperative pain in obese patients undergoing bariatric surgery. Further studies are needed to delineate the limits and extents of its efficacy.