Analgesic Efficacy and Outcome of Lumber Epidural Analgesia versus ultrasound guided Trasversus Abdominis Plane block In Laparoscopic Sleeve Gastrectomy

Abstract

The transversus abdominis plane (TAP) block provide effective postoperative analgesia in lower abdominal surgery. Subcostal TAP block as a new technique to provide analgesia for the supraumbilical abdomen. Traditionally, pain relief for these patients is provided by epidural analgesia or IV opioid analgesia. Although epidural analgesia is currently the “gold standard” for postoperative pain treatment, associated complications and contraindications may limit its use. IV opioid analgesia may cause opioid-related side effects and be associated with inadequate analgesia. We compared the analgesic effect between subcostal ultrasound TAP block and lumber epidural analgesia in laparoscopic sleeve gastrectomy. Sixty patients undergoing elective Laparoscopic sleeve gastrectomy were randomized to receive either subcostal TAP block (group TAP), Lumber epidural analgesia (group epidural), and were analyzed. The peri-operative management was identical in the two groups apart from the insertion of subcostal TAP, In Epidural group lumber epidural was inserted pre- operatively.