Does laparoscopic-guided transversus abdominis plane block have an effect on postoperative pain and recovery after sleeve gastrectomy?

- OBJECTIVE: Postoperative pain management is thought to have an effect on pa-tient comfort, morbidity, and mortality after bar-iatric surgery. Local anesthetic agents are fre-quently used for this purpose. Local anesthetics can be used in many different ways. In this study, we aimed to investigate the effect of transversus abdominis plane (TAP) block on postoperative pain by laparoscopic method.PATIENTS AND METHODS: A prospective randomized clinical trial was performed. While TAP block was applied to one group with bupiv-acaine, no action was taken for the other group. Postoperative analgesia was given to both pa-tient groups with the "patient-controlled anal-gesia (PCA)" device. Demographic, operational, and postoperative clinical and pain data of the patients were recorded. RESULTS: TAP block and non-TAP block groups consisted of 30 patients each. Visual analog scale (VAS) scores of the patients at 6, 12, and 24 hours were lower in the TAP group compared to the non -TAP group (p=0.015, 0.018, 0.04, respectively). Ac-cording to the PCA device data, the analgesic re-quirement was lower in the TAP group at 6, 12, and 24 hours (p <0.001). Rescue analgesia was re-quired more in the non-TAP group (p=0.04). There was no statistically significant difference between the two groups in terms of gas discharge time (p=0.102), stool discharge occurred earlier in the TAP group (p=0.02). Oral intake times (p=0.554) and length of stay hospital (p=0.551) were similar.CONCLUSIONS: Laparoscopic TAP block us-ing bupivacaine can be safely administered in morbidly obese patients and reduces postoper-ative analgesic requirements. Thus, side effects that may develop secondary to the use of anal-gesics are avoided.