Evaluation of the effect of Transversus Abdominis Plane (TAP) block on post-laparoscopic cholecystectomy stress responses: a randomized controlled trial

Abstract

Background: The term “surgical stress response” refers to the physiologic response to surgery. The study aimed to evaluate effects of transversus abdominal plane (TAP) block on post-surgical stress responses. Methods: This is a randomized, parallel-group clinical trial consisting of 60 patients undergoing laparoscopic cholecystectomy. Participants were randomized into two groups receiving either general anesthesia or general anesthesia plus TAP block. Blood samples for stress responses evaluating were obtained before anesthesia induction, 6 hours after extubation, and 24 hours after surgery termination. Pain levels were assessed after discharge from the recovery room and at intervals of 6, 12, and 24 hours after surgery. Results: The trend in mean levels of blood sugar, cortisol, and WBC in each group was significant in the course of 24 hours. The mean levels of blood sugar and CRP was not significantly different between two groups; however, serum cortisol and WBC levels were different. Moreover, levels of IL-1 at 6 and 24 hours after surgery were significantly lower in the TAP block group. In Spearman’s rank-order correlation analysis, age, BMI, pain level, cortisol, baseline IL-1, and TNF-α level had a significant linear correlation with IL-1 levels. There was a significant difference in pain scores between the two groups at 6 and 12 hours; however, at 24 hours, the difference was not statistically significant. The mean opioid consumption was significantly lower in the TAP block group. Conclusion: This study showed the remarkable effects of TAP block on stress responses and pain scores.

Keywords

• clinical trial
• stress responses
• transversus abdominal plane block