S.Gupta, Arya S, El-Medani F, Walker T (2015) Role of Transversus Abdominis Plane (TAP) Block in Day Case Laparoscopic Cholecystectomy (DCLC) - A Prospective Study. Int J Anesth Res. 3(3), 96-100. 96 http://scidoc.org/IJAR.php International Journal of Anesthesiology & Research (IJAR) ISSN 2332-2780 Role of Transversus Abdominis Plane (TAP) Block in Day Case Laparoscopic Cholecystectomy (DCLC) - A Prospective Study Brief Discussion S.Gupta 1* , Arya S 2 , El-Medani F 2 , Walker T 3 1 Consultant Surgeon, Department of Surgery, Lister Hospital, Stevenage, UK. 2 Registrar Surgery, Department of Surgery, Lister Hospital, Stevenage, UK. 3 Consultant Anaesthetist, Department of Anaesthesia, Lister Hospital, Stevenage, UK.. *Corresponding Author: S.Gupta FRCS, FACS, Consultant General Surgeon, Lister Hospital, Coreys Mill Lane, Steve- nage, Herts, SG1 4AB, UK. Tel: 00 44 7958303566 Fax: 00 44 1438 285177 E-Mail: sanjay.gupta@nhs.net Received: March 17, 2015 Accepted: April 09, 2015 Published: April 13, 2015 Citation: S.Gupta, Arya S, El-Medani F, Walker T (2015) Role of Trans- versus Abdominis Plane (TAP) Block in Day Case Laparoscopic Chol- ecystectomy (DCLC) - A Prospective Study. Int J Anesth Res. 3(3), 96-100. Copyright: S.Gupta © 2015. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Introduction LC is the technique of choice for removal of gallbladder with be- nign pathology. Rapid improvements in surgical and anaesthetic techniques coupled with advancements in instrumentation and optics has now made LC a standard day case procedure [1]. Brit- ish Association of Day Surgery (BADS) believes a day case rate of 60% is achievable for LC by most hospitals [2]. Despite the ad- vances, considerable variation still remains across various centres in United Kingdom. National average DCLC rate for England was reported to be 16% in a recent study [3]. Many clinical concerns remain unaddressed preventing a more widespread adoption of DCLC. Of these, post-operative pain and nausea remains a challenging issue, limiting the success of same day discharge. TAP block, irst described in 2001 [4] is an effective adjunct to post-operative analgesia especially following lower abdominal in- cisions [5]. The technique has been used previously to provide analgesia following DCLC with mixed results [6-9]. Reduced pain could potentially translate into low opiate requirements and hence reduced sedation and opiate induced nausea and vomiting. Materials and Methods Participants and Inclusion Criteria All patients deemed suitable for DCLC in an established day sur- Abstract Background: Despite being accepted as a standard day case procedure, day case rates for laparoscopic cholecystectomy (LC) remain low. Post-operative pain, nausea and vomiting continue to be important obstacles to early discharge. Present study was undertaken to assess the role of transversus abdominis plane (TAP) block as an analgesic adjunct in improving procedure related outcomes for patients undergoing day case laparoscopic cholecystectomy (DCLC). Methods: Patients undergoing day case DCLC were prospectively randomised to TAP and no TAP block groups after in- formed consenting. Patients in both the groups also received port site iniltration with Marcaine. Primary outcome measure was post-operative pain. Secondary outcome measures included post-operative nausea/vomiting scores, sedation scores, length of post-operative hospital stay, complication rates, re-admission rates and overall patient satisfaction scores. Results: A total of 53 patients undergoing DCLC were randomised into TAP block (26) and no TAP block (27) groups. Both the groups were well matched for age, sex, ASA (American society of anaesthesiologists) grade and BMI (Body mass index). No signiicant differences were noted in the post-operative pain scores when measured at 2h (p-0.810), 4h (p-0.993), at discharge (p-0.539) and irst post-operative day (p-0.491). Average post-operative hospital stay was 5.86h (4-8h) in the TAP group and 6.38h (5-22h) in the no TAP group (p-0.482). Post-operative nausea and sedation scores assessed at similar intervals did not reveal any signiicant difference between the two groups. Complication rates (3 patients in each group) and re-admission rates (none in each group) were similar for both the groups. Overall 42 patients (21 in each group) described the experience as highly satisfying with 9 patients reporting as satisfying (TAP-5, No TAP-4). Conclusion: The study failed to prove any beneit from TAP block in patients undergoing elective DCLC. Keywords: Laparoscopic Cholecystectomy; Day Case Laparoscopic Cholecystectomy; Transversus Abdominis Plane Block; TAP Block.