Background: Laparoscopic cholecystectomy is the surgical removal of gall bladder and is the common treatment of symptomatic gall stone and other GB conditions. Laparoscopic cholecystectomy can be performed under general anaesthesia which is frequently associated with persistent postoperative pain.
Aim of work: comparing between adding ketamine to bupivacaine and bupivacaine alone for postoperative pain in patients receiving ultrasound guided subcostal transversus abdominis plane block (TAPB) after laparoscopic cholecystectomy regarding the time of the first request for additional analgesia, pain Scores, total analgesic consumption and analgesic efficacy.
Patients and methods: This study was carried out in al-azhar university hospital on 28 adult patients aged 30 to 60 years, American society of anesthesiologists (ASA) class I - II scheduled for laparoscopic cholecystectomy. Patients were randomized, double blind controlled into two equal groups (fourteen patients each).
Results: The Comparison between the two studied groups according to time till first opioids requirement, the duration of the block, requirement for opioids, early ambulation, patients satisfaction and the incidence of nausea and vomiting was statistically insignificant. As regarding patient complication no local anaesthetic toxicity no hematoma or excessive tissue trauma had been developed at the site of injection in both group.
Conclusion: Addition of ketamine to bupivacaine in patients receiving subcostal (TAPB) guided with ultrasound for laparoscopic cholecystectomy result in statistically insignificant longer time till first opioids requirement and prolonged the duration of the block, statistically insignificant fewer requirement for opioids and statistically insignificant early ambulation, patient more satisfied.
Keywords: Bubivacaine, Bubivacaine-Ketamine, Ultrasound, Analgesia, Laparoscopic Cholecystectomy