Plenary Session
AB095. SOH25_AB_278. Laparoscopic-assisted transversus abdominis plane block versus port-site infiltration in appendicectomy: a multicentre randomised controlled trial
Gavin Dowling, Gordon Daly, Sandra Hembrecht, Sorcha O’Grady, Aisling Hegarty, Trudi Roche, Jan Sorenson, Colm Power, David Kearney, Abeeda Butt, Michael Boland, Andrew McGuire, Ishwarya Balasubramanian, Niamh McCawley, Deborah McNamara, John Burke, William Robb, Achille Mastrosimone, Mayilone Arumugasamy, Hugo Prins, David Beddy, Gerard Curley, Sami Abd Elwahab, Arnold Hill
Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
Background: Transversus abdominis plane (TAP) block has been shown to be an effective technique in providing post-operative analgesia across a range of intra-abdominal surgeries. Laparoscopic-assisted TAP (LTAP) block is a recent advancement of this technique. This study aimed to evaluate the effectiveness of LTAP block compared to port site infiltration (PSI) in patients undergoing laparoscopic appendicectomy.
Methods: A single-blinded randomised controlled trial was performed to compare LTAP to standard PSI after completing laparoscopic appendicectomy. Patients diagnosed with acute appendicitis, clinically or radiologically, were randomised to either group in a 1:1 fashion. Patients in both groups received the same perioperative analgesic regimen. The primary outcome measure was to compare post-operative pain using a visual-analogue scale (VAS). Secondary outcomes included length of hospital stay (LOS), post-operative opioid requirement and a follow up quality of life (QOL) questionnaire at 1 week and 1 month post discharge.
Results: A total of 174 patients were enrolled and randomly allocated to the study arms; 85 in LTAP and 82 in control (PSI) group were eligible for analysis. The LTAP group had significantly lower VAS pain scores at 6 hours (P<0.001), 12 hours (P<0.001) and 24 hours (P=0.002) post-operatively. There was no significant difference in VAS scores at 3 hours post-operatively (P=0.15), in LOS (P=0.45) or in opioid requirements on the ward (P=0.42). QOL scores were better in LTAP group at 1 week follow-up (P=0.04).
Conclusions: LTAP block significantly improved post-operative analgesia outcomes in patients undergoing laparoscopic appendicectomy and holds promise as part of an effective post-operative analgesic regimen.
Keywords: Appendicectomy; analgesia; laparoscopic; TAP block; randomised controlled trial
Acknowledgments
None.
Funding: None.
Conflicts of Interest: The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/map-25-ab095
Cite this abstract as: Dowling G, Daly G, Hembrecht S, O’Grady S, Hegarty A, Roche T, Sorenson J, Power C, Kearney D, Butt A, Boland M, McGuire A, Balasubramanian I, McCawley N, McNamara D, Burke J, Robb W, Mastrosimone A, Arumugasamy M, Prins H, Beddy D, Curley G, Elwahab SA, Hill A. AB095. SOH25_AB_278. Laparoscopic-assisted transversus abdominis plane block versus port-site infiltration in appendicectomy: a multicentre randomised controlled trial. Mesentery Peritoneum 2025;9:AB095.
