Modified thoracoabdominal nerves block through perichondrial approach for laparoscopic cholecystectomy

We sought to compare the analgesic efficacy of the modified thoracoabdominal nerves block through perichondrial approach block with
local anesthetic infiltration at the port sites in an adult population who underwent laparoscopic cholecystectomy.
METHODS: Patients who will undergo laparoscopic cholecystectomy were randomized to receive bilateral ultrasound-guided modified thoracoabdominal
nerves block through perichondrial approach blocks or local anesthetic infiltration at the port insertion sites. The primary outcome was the total
amount of tramadol used in the first 12 h postoperatively. The secondary outcomes were total IV tramadol consumption for the first postoperative
24 h and visual analog scale scores.
RESULTS: The modified thoracoabdominal nerves block through perichondrial approach group had significantly less tramadol use in the first 12 h
postoperatively (p<0.001). The modified thoracoabdominal nerves block through perichondrial approach group’s visual analog scale scores at rest
(static) and with movement (dynamic) were significantly lower compared with the port infiltration group (p<0.05).
CONCLUSION: Patients who received modified thoracoabdominal nerves block through perichondrial approach block had significantly less analgesic
consumption and better pain scores than those who received port-site injections after laparoscopic cholecystectomy.
KEYWORDS: Laparoscopic cholecystectomy. Nerve block. Postoperative pain. Anesthetics, local.