a comparative study to evaluate the effectiveness of perioperative multi modal analgesia with ultrasound guided bilateral subcostal tap block for post-operative analgesia in patients undergoing elective laparoscopic cholecystectomy under general anaesthes

Background: laparoscopic cholecystectomy is usually performed as a day care procedure for diseases involving the gall bladder. pain in the immediate post-operative period is due to multiple factors and hence different modalities of pain relief are used. the present study was conducted to study the effectiveness of peri-operative multi-modal analgesia with ultrasound guided bilateral subcostal tap block for post-operative analgesia in 60 patients undergoing elective laparoscopic cholecystectomy. methods: in this hospital based, randomized prospective interventional study patients were randomly allocated into 4 groups of 15 in each group, group b received bilateral ultrasound guided subcostal tap block with 20 ml of 0.25% bupivacaine, group p received tab pregabalin tablet 150 mg, group d received inj dexamethasone 8 mg iv and group c was the control group. the hemodynamic changes like heart rate, blood pressure, saturation was monitored both intra and post operatively. the post-operative vas scoring, duration of analgesia, time for first rescue analgesic and the total dose of analgesics in 24 hours were noted. results: the vas scores indicated that group b> p> d> c provided better analgesia to the patients with a p value of < 0.01. group b took the longest mean duration (6.8± 1.15 hours) to take the 1st rescue analgesic and least mean total dose of rescue analgesic in 24 hours followed by group p, group d and group c which was statistically significant. conclusion: usg guided b/l tap block was superior to other modalities in providing postoperative analgesia for patients undergoing laparoscopic cholecystectomy.