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23 December 2014 : Original article

Effect of Transversus Abdominis Plane Block on Cost of Laparoscopic Cholecystectomy Anesthesia

Serdar KokuluABE, Elif Doğan BakıCF, Emre KaçarBDG, Ahmet BalAF, Hasan ŞenayCE, Kübra Demir ÜstünDE, Sezgin YılmazAB, Yüksel ElaF, Remziye Gül SıvacıG

DOI: 10.12659/MSM.892055

Med Sci Monit 2014; 20:2783-2787

Abstract

BACKGROUND: Use of transversus abdominis plane (TAP) block for postoperative analgesia is continuously increasing. However, few studies have investigated intraoperative effects of TAP block. We aimed to study the effects of TAP block in terms of cost-effectiveness and consumption of inhalation agents.

MATERIAL AND METHODS: Forty patients undergoing laparoscopic cholecystectomy were enrolled in this study. Patients were randomly divided into 2 groups: Group 1 (n=20) patients received TAP block and Group 2 (n=20) patients did not receive TAP block. Standard anesthesia induction was used in all patients. For the maintenance of anesthesia, fractional inspired oxygen (FIO2) of 50% in air with desflurane was used with a fresh gas flow of 4 L/min. All patients were monitored with electrocardiography and for peripheral oxygen saturation (SpO2), end-tidal carbon dioxide (ET), heart rate (HR), noninvasive mean blood pressure (MBP), and bispectral index (BIS). Bilateral TAP blocks were performed under ultrasound guidance to Group 1 patients. The BIS value was maintained at between 40 and 50 during the surgery. The Dion formula was used to calculate consumption of desflurane for each patient.

RESULTS: There was no difference between the groups with respect to demographic characteristics of the patients. Duration of anesthesia, surgery time, and dosage of fentanyl were similar in the 2 groups. However, the cost and consumption of desflurane was significantly lower in Group 1.

CONCLUSIONS: Total anesthesia consumption was lower and the cost-effectiveness of anesthesia was better in TAP block patients with general anesthesia than in non-TAP block patients undergoing laparoscopic cholecystectomy.

Keywords: Adult, Abdominal Muscles - surgery, Anesthesia - economics, arterial pressure, Cholecystectomy, Laparoscopic - economics, Dose-Response Relationship, Drug, Health Care Costs, Isoflurane - pharmacology, Nerve Block - economics, Time Factors

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750