Pain control in laparoscopic surgery: a case–control study between transversus abdominis plane-block and trocar-site anesthesia

  • Sarah MolfinoEmail author
  • Emanuele Botteri
  • Paolo Baggi
  • Luigi Totaro
  • Michela Huscher
  • Gian Luca Baiocchi
  • Nazario Portolani
  • Nereo Vettoretto
Original Article


Local anesthesia in laparoscopic operations is gaining increasing consensus. To standardize analgesia, a prospective case–control study was created over a 1-year period, in collaboration with the anesthesiology service in our community hospital. Starting from February 2016, we prospectively enrolled adult patients (more than 16 years old) undergoing laparoscopic appendectomy or cholecystectomy, either in emergency or elective setting. Patients were preoperatively assigned (based on the chart-admission number) either to transversus abdominis plane (TAP) block treatment (Group 1—experimental arm) or trocar-site anesthesia (TSA) (Group 2—experimental arm), and then compared with group of patients not submitted to treatment (Group 3—control arm). Demographic and clinical characteristics of each patient were recorded. Post-operative pain level (primary outcome) was assessed with visual analog scale (VAS) score; analgesic use and length of stay in hospital were defined as secondary outcomes. Forty-two patients were assigned to TAP block treatment (Group 1), fifty-two to TSA (Group 2), and thirty-nine underwent no pre-incisional treatment (Group 3). In the comparison between patients undergoing TAP block or TSA with the control arm, a significance difference in reported pain was recorded in every scheduled time (p < 0.05 at 0, 6, 12, 18, 24, and 48 h from awakening). Both local anesthesia groups share a benefit in terms of primary outcome. The use of pre-incisional TSA for all the patients undergoing laparoscopic cholecystectomy and appendectomy could become a routine practice to reduce post-operative pain both in the elective and emergency setting.


Pain control Laparoscopic surgery Post-operative pain TAP block Trocar-site anesthesia 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This research involving human participants was in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants and/or animals

This research involved human participants who supplied their own consent. This study was performed in accordance with the ethical standards of the Declaration of Helsinki. All authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence this study.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  1. 1.Department of Clinical and Experimental Sciences, Surgical ClinicUniversity of BresciaBresciaItaly
  2. 2.Surgical UnitMontichiari Hospital, Spedali Civili di BresciaBresciaItaly
  3. 3.Intensive Care UnitMontichiari Hospital, Spedali Civili di BresciaBresciaItaly

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