A RANDOMISED CONTROLLED TRIAL COMPARING THE EFFICACY OF BUPIVACAINE AND ROPIVACAINE IN ULTRASOUND GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK FOR POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC CHOLECYSTECTOMY

Background :Ttransversus abdominis plane (TAP) block is a regional analgesic technique that blocks abdominal neural afferents by introducing local anaesthetic into the neurofascial plane between internal oblique and the transversus abdominis muscles thereby reducing the post operative pain of abdominal surgeries.

Method :  We evaluated the relative efficacy of bupivacaine 0.25% and ropivacaine 0.375% in ultrasound guided TAP block for postoperative analgesia in laparoscopic cholecystectomy. 60 adult ASA I & II patients undergoing elective laparoscopic cholecystectomy were randomized using computer coded sealed envelope to recieve either USG TAP block with 0.25% bupivacaine or 0.375% ropivacaine at the end of surgical procedure prior to extubation. All patients were assessed for postoperative pain, nausea vomiting and rescue analgesic consumption for upto 24 hours in the postoperative period.

Result : patients receiving USG TAP block with ropivacaine had significantly lower visual analog scale pain scores at 10 min, 30 min and 1 hour as compared to patients receiving USG TAP block with bupivacaine. beyond that both drugs are equal in their efficacy with respect to postoperative analgesia and 24 hrs cumulative rescue analgesic requirement. there were no complications attributable to TAP block.

Conclusion : USG TAP block is an effective regional analgesic technique for postoperative pain relief in patients undergoing laparoscopic cholecystectomy. ropivacaine has early onset of analgesia and provides better quality of pain relief in the immediate postoperative period upto 1 hour in comparison to bupivacaine. thereafter, both the drugs are equal in their efficacy in terms of postoperative analgesia and 24 gours cumulative rescue analgesic requirement.