Comparative Analgesic Efficacy of Ultrasound-Guided Single-Shot and Continuous TAP Block Versus IV-PCA in Laparoscopic Cholecystectomy

Background: Despite minimal invasiveness, laparoscopic cholecystectomy causes significant postoperative pain. Opioid-based IV-PCA is effective but associated with adverse effects. Ultrasound-guided transversus abdominis plane (TAP) block offers an opioid-sparing alternative; however, the benefit of continuous infusion over singleshot block remains unclear. Aim: To compare analgesic efficacy of ultrasound-guided single-shot TAP block, continuous TAP block, and IVPCA following laparoscopic cholecystectomy. Methodology: In this prospective randomized controlled study, 90 ASA I–II patients were allocated into three groups (n=30 each): Group A–IV-PCA, Group B–single-shot TAP + IV-PCA, and Group C–continuous TAP block. Pain scores (NRS) were assessed up to 48 hours. Opioid consumption, rescue analgesia, complications, and patient satisfaction were recorded. Result: Demographics were comparable. Pain scores at rest and movement were highest in Group A, intermediate in Group B, and lowest in Group C at all intervals (p<0.001). Mean oxycodone consumption decreased from 28.4±6.2 mg (A) to 18.7±5.1 mg (B) and 10.9±4.3 mg (C). Rescue analgesia requirement was 70%, 33.3%, and 13.3% respectively. Nausea and vomiting were significantly lower in Group C. Patient satisfaction was highest with continuous TAP block (excellent 66.7%). Conclusion: Continuous TAP block provides superior and prolonged analgesia with reduced opioid use and complications compared with single-shot TAP block and IV-PCA, making it the most effective modality after laparoscopic cholecystectomy.