Efficacy of transversus abdominis plane (TAP) block in pain management after laparoscopic sleeve gastrectomy (LSG): A double-blind randomized controlled trial.

BACKGROUND: The aim of this randomized controlled trial was to assess the effectiveness of transversus abdominis plane (TAP) block in post-operative pain management in patients undergoing laparoscopic sleeve gastrectomy (LSG).

METHODS: Ninety consecutive patients undergoing LSG were randomly assigned to three groups: placebo, TAP block with 0.25% bupivacaine (40mL total), and TAP block with 0.25% bupivacaine + 1/100,000 epinephrine (40mL total). Pain and nausea/vomiting scores were evaluated at varying times until discharge. Other parameters included, additional analgesia required, time to ambulation, length of stay and time required for return to work after discharge.

RESULTS: There was decrease in post-operative pain 3 hours after surgery between the placebo group and the bupivacaine group and between the placebo group and the bupivacaine with epinephrine group, however, no difference in 1, 6, 12 and every 6 hours after. There was no significant difference in post-operative analgesia requirements, nausea/vomiting scores, time to ambulation, hospital length of stay, or time to return to work after discharge.

CONCLUSION: The efficacy of TAP block is not apparent likely due to the ERAS protocol set in place for bariatric surgery, which already targets early postoperative pain control and mobility.