Comparison of paravertebral block and intravenous analgesic methods on postoperative pain and opioid consumption in patients undergoing laparoscopic chloecystectomy

Comparison of paravertebral block and intravenous analgesic methods on postoperative pain and opioid consumption in patients undergoing laparoscopic chloecystectomy. Objective: The aim of this study was to evaluate the efficiency of preoperative TPVB on postoperative analgesia in elective laparoscopic cholecystectomies under general anesthesia. Materials and methods: After institutional ethics committee approval and informed consents; 78 patients aging between 18-70 years, with ASA I-III physical status scheduled for elective laparoscopic cholecystectomy were enrolled to the study. Patients were randomly seperated into two groups: Group 1; TPVB performed before surgery and Group 2; receiving general anesthesia alone. Postoperatively, patients in both groups received Patient-Controlled Analgesia with CADD-Legacy® PCA. Unilateral ultrasound-guided TPVB was performed to patients in Group 1 preoperatively. VAS scores at rest and on movement were recorded during postoperative first 24 hours in both groups. Tramadol consumption during first 24 hours, nause and vomiting rate, time to first passing bowel gas and defecation, nutrition, mobilization and disharge hours were also noted. Results: The patients received US guided TPVB preoperatively had significantly lower postoperative VAS scores at rest and on movement at 4th, 6th, 12th,18th, and 24th hours. The patients received TPVB had significantly lower tramadol consumption postoperatively. 77.5% of the patients who didn't receive TPVB preoperatively had fentanyl requirement at least one time in the intraoperative period. Patients in Group 2 had a higher vomiting rate significantly. It was observed that the first passing bowel gas and defecation time, nutrition and mobilization time of the patients who didn't receive TPVB were later. There was no significant difference between the discharge hours of both groups. Conclusion: In this study, preoperatively performed TPVB resulted in an efficient analgesia after laparoscopic cholecystectomy. Also we observed TPVB can also reduce perioperative, and postoperative opioid requirements. Key words: Laparoscopic cholecystectomy, bupivacaine, fentanyl, tramadol, paravertebral block