Comparative Study of Ultrasound Guided Transversus Abdomininis Plane Block using Bupivacaine with and without Hyaluronidase in Laparoscopic Bariatric Surgery

Abstract

besity is a serious global epidemic and poses a significant health threat to humans such as type 2 diabetes mellitus (T2DM), chronic kidney disease, depression, stroke, coronary artery disease (CAD), osteoarthritis, back pain, stress incontinence, gallstones and malignancies. These conditions are a result of both physiologic changes as well as inflammatory changes associated with obesity. These comorbidities, in addition to the type and invasiveness of anesthesia and surgical procedure, are correlated with the incidence and severity of postoperative complications. Over 220,000 bariatric procedures, including laparoscopic gastric-bypass surgery (LGBS), are performed annually worldwide and this number is increasing exponentially. Postoperative analgesia after surgeries under general anesthesia is usually provided by systemic opioids, non-steroidal anti-inflammatory drugs or epidural analgesia. Other techniques which have been effectively used are Transversus Abdominis Plane (TAP) block and paravertebral block. Transversus abdominis plane (TAP) block is an excellent technique of regional anesthesia especially for our targeted obese patients, as it reduces the pain derived from