ประสิทธิผลของการทำ  Subcostal Transversus Abdominis Plane Block ด้านขวา ด้วยเทคนิคอัลตราซาวด์นำทาง  เพื่อบรรเทาอาการปวดในการฟื้นตัวหลังการผ่าตัดถุงน้ำดีด้วยวิธีส่องกล้อง

Jitpattra Nganlasom; Ariyachart  Kalawa; Piyarat Boonphila; Waraporn Buanak

doi:10.64960/srimedj.v41i3.270574

Authors

Jitpattra Nganlasom Department of Anesthesiology, Sakon Nakhon Hospital, Mueang District, Sakon Nakhon Province, Thailand 47000
Ariyachart Kalawa Department of Nurse Anesthesia, Sakon Nakhon Hospital, Mueang District, Sakon Nakhon Province, Thailand 47000
Piyarat Boonphila Department of Nurse Anesthesia, Sakon Nakhon Hospital, Mueang District, Sakon Nakhon Province, Thailand 47000
Waraporn Buanak Department of Nurse Anesthesia, Sakon Nakhon Hospital, Mueang District, Sakon Nakhon Province, Thailand 47000

DOI:

https://doi.org/10.64960/srimedj.v41i3.270574

Keywords:

postoperative pain, regional anesthesia, laparoscopic cholecystectomy, subcostal transversus abdominis plane block

Abstract

Backgrounds and objective: Pain management is the important part of enhanced recovery after surgery programs. Ultrasound-guided subcostal transversus abdominis plane (TAP) block is an effective regional anesthesia technique for reducing postoperative pain following laparoscopic cholecystectomy. Although bilateral subcostal TAP block has been shown to be effective in providing analgesia and reducing opioid consumption after laparoscopic cholecystectomy, there is still no clear conclusion regarding the efficacy of a unilateral approach. The primary objective of this study is to compare the effectiveness of 24-hour postoperative morphine consumption between patients receiving a right unilateral subcostal TAP block and those in the control group.

Methods: This randomized controlled trial included 43 patients undergoing laparoscopic cholecystectomy between August and December 2025. Participants were randomly assigned to either the subcostal TAP block group or the control group. Compare 24-hour postoperative morphine consumption, pain scores at rest and on movement at 12 and 24 hours using the Numerical Rating Scale (NRS), and postoperative complications.

Results: Ultrasound-guided right Subcostal Transversus Abdominis Plane (TAP) Block significantly reduced total morphine consumption within 24 hours postoperatively. The median morphine consumption was 0 (0, 0) mg in the TAP block group, compared to 4 (2, 7) mg in the control group (p < 0.001). Regarding postoperative pain, the median pain score at rest at 12 hours was 0 (0, 0) in the block group, which was significantly lower than 2 (1.25, 3) in the control group (p < 0.001). The median pain score on movement at 12 hours was 2 (2, 3) in the block group versus 3 (3, 5.75) in the control group (p = 0.026). At 24 hours, the median pain score at rest was 0 (0, 0) in the block group compared to 1 (0, 1) in the control group (p = 0.026). No complications related to the TAP block or surgery were observed in this study.

Conclusions: Ultrasound-guided right subcostal transversus abdominis plane (TAP) block is an effective and safe technique for reducing postoperative opioid consumption within 24 hours, as well as postoperative pain at 12 and 24 hours, following laparoscopic cholecystectomy.

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