Introduction:

Laparoscopic cholecystectomy is the standard treatment for cholelithiasis. Though considered minimally invasive, postoperative pain—mainly from port site trauma, pneumoperitoneum, and hepatic bed irritation—can still affect patient comfort. Pain is usually localized to the right upper quadrant and port sites. A subcostal transversus abdominis plane (TAP) block offers regional anesthesia by targeting nerves of the anterior abdominal wall and may reduce the need for systemic analgesics.

Aim:To evaluate the analgesic efficacy of laparoscopic-assisted subcostal TAP block versus standard postoperative pain management.

Methods:This randomized, double-blinded controlled trial (CTRI No: REF/2022/08/057543) was conducted at AIMSR, Hyderabad over 12 months, enrolling 48 patients undergoing elective laparoscopic cholecystectomy.

·         Group A (n=24): Received bilateral TAP block with 0.25% Bupivacaine (20 ml per side).

·         Group B (n=24): Received intravenous Paracetamol 1g TID.

Patients were randomized using a coin-flip method. Pain was assessed using the Visual Analogue Scale (VAS) at 12 and 24 hours postoperatively. Heart rate and blood pressure were also monitored.

Inclusion: All patients scheduled for elective laparoscopic cholecystectomy.Exclusion: Allergy to local anesthetics or NSAIDs.

Results:VAS scores at 12 hours were significantly lower in the TAP block group (p = 0.018), with no significant difference at 24 hours (p = 0.199). Hemodynamic parameters were similar between groups.

Conclusion: The laparoscopic-assisted TAP block using Bupivacaine is a safe and effective method for improving early postoperative pain control after laparoscopic cholecystectomy

Dr. Varshitha Chowdary Nallapati is currently completing her medical internship at Apollo Institute of Medical Sciences & Research, Hyderabad, having graduated with first-class division in MBBS. She has developed a strong interest in General Surgery and hopes to specialize in Pediatric Surgery. She has enjoyed the clinical exposure throughout her internship and finds surgical cases particularly engaging. She values the practical learning that comes with patient care and is eager to continue growing in the field.