International Journal of Medical and All Body Health Research  |  e-ISSN: 2582-8940  |  Double-Blind Peer Review  |  Open Access  |  CC BY-NC-SA 4.0

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     2026:7/4

International Journal of Medical and All Body Health Research

e-ISSN: 2582-8940 | Open Access

Comparison of Subcostal Transversus Abdominis Plane Block with Intraperitoneal Instillation of Levobupivacaine 0.25% for Pain Relief After Laparoscopic Cholecystectomy

Dr. Bobi Bhati, Dr. Shailja Sharma, Dr. Keshav Dev Jagar, Dr. Kajal Sharma, Dr. Manish Madhrey

Postgraduate Resident, Department of Anesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; HOD & Professor, Department of Anesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Associate Professor, Department of Anesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Senior Resident MS General Surgery, Department of Anesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Senior Resident, Department of Anesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India

Article Information

Volume / Issue6 / 3 (July-September 2025)
Pages93-98
AccessOpen Access

Publication Timeline

  • Received18 June 2025
  • Accepted19 July 2025

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Abstract

Background: Laparoscopic cholecystectomy, despite being minimally invasive, is associated with significant postoperative pain that can delay recovery and discharge. This study aimed to compare the efficacy of subcostal transversus abdominis plane (TAP) block with intraperitoneal instillation of levobupivacaine 0.25% for postoperative pain management following laparoscopic cholecystectomy.
Methods: A prospective, randomized, double-blind study was conducted on 120 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups: Group T (n=60) received bilateral subcostal TAP block with 20 mL of 0.25% levobupivacaine on each side, and Group I (n=60) received intraperitoneal instillation of 40 mL of 0.25% levobupivacaine. Primary outcome was postoperative pain scores using Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours. Secondary outcomes included time to first analgesic request, total analgesic consumption, patient satisfaction scores, and adverse effects.
Results: Both groups showed significant reduction in postoperative pain compared to historical controls. Group T demonstrated significantly lower VAS scores at 2 hours (3.2±1.1 vs 4.1±1.3, p<0.001), 6 hours (2.8±1.0 vs 3.6±1.2, p<0.001), and 12 hours (2.1±0.9 vs 2.9±1.1, p<0.001) compared to Group I. Time to first analgesic request was longer in Group T (8.4±2.3 hours vs 6.2±1.8 hours, p<0.001). Total tramadol consumption in 24 hours was significantly lower in Group T (150±45 mg vs 210±60 mg, p<0.001). Patient satisfaction scores were higher in Group T (8.2±1.1 vs 7.4±1.3, p<0.001). No significant adverse effects were observed in either group.
Conclusion: Bilateral subcostal TAP block provides superior postoperative analgesia compared to intraperitoneal instillation of levobupivacaine 0.25% following laparoscopic cholecystectomy, with longer duration of analgesia, reduced analgesic requirements, and higher patient satisfaction scores.
 

Keywords

Transversus Abdominis Plane BlockIntraperitoneal InstillationLevobupivacaineLaparoscopic CholecystectomyPostoperative AnalgesiaRegional Anesthesia

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How to Cite

Bhati, B., Sharma, S., Jagar, K. D., Sharma, K., & Madhrey, M. (2025). Comparison of Subcostal Transversus Abdominis Plane Block with Intraperitoneal Instillation of Levobupivacaine 0.25% for Pain Relief After Laparoscopic Cholecystectomy. International Journal of Medical and All Body Health Research, 6(3), 93-98. https://doi.org/10.54660/IJMBHR.2025.6.3.93-98

Bhati, Bobi, et al. "Comparison of Subcostal Transversus Abdominis Plane Block with Intraperitoneal Instillation of Levobupivacaine 0.25% for Pain Relief After Laparoscopic Cholecystectomy." International Journal of Medical and All Body Health Research, vol. 6, no. 3, 2025, pp. 93-98. https://doi.org/10.54660/IJMBHR.2025.6.3.93-98.

Bhati, B., Sharma, S., Jagar, K. D., Sharma, K. and Madhrey, M. (2025) 'Comparison of Subcostal Transversus Abdominis Plane Block with Intraperitoneal Instillation of Levobupivacaine 0.25% for Pain Relief After Laparoscopic Cholecystectomy', International Journal of Medical and All Body Health Research, 6(3), pp. 93-98. doi: 10.54660/IJMBHR.2025.6.3.93-98.

Bhati B, Sharma S, Jagar KD, Sharma K, Madhrey M. Comparison of Subcostal Transversus Abdominis Plane Block with Intraperitoneal Instillation of Levobupivacaine 0.25% for Pain Relief After Laparoscopic Cholecystectomy. International Journal of Medical and All Body Health Research. 2025;6(3):93-98. doi:10.54660/IJMBHR.2025.6.3.93-98

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