Page 58 - GALENIKA MEDICAL JOURNAL

Zaključak

TAP blok je tokom proteklih godina bio tema brojnih istraživanja. Pregledom različitih studija o
primjeni TAP bloka kod pacijenata podvrgnutih laparoskopskoj holecistektomiji, može se zaključiti
da se primjenom ovog bloka postiže efikasnija kontrola bola od konvencionalne kontrole upotrebom
isključivo opioda i drugih analgetika različitim sistemskim putevima unošenja. Primjena TAP bloka
dovodi do smanjenja intenziteta bola na VAS skali, kao i do smanjenja neželjenih efekata nakon

operacije, poput postoperativne mučnine i povraćanja. Ipak potrebno je sprovesti veća istraživanja
koja bi utvrdila adekvatnost količine i koncentracije lokalnog anestetika potrebnih za efikasno
izvođenje TAP bloka uz minimalan rizik za nastanak komplikacija. Razvoj strategija multimodalne
analgezije, zasnovanih na primjeni sistemskih analgetika i tehnika regionalne anestezije, imaju za
cilj smanjenje perioperativnog bola, smanjenje komplikacija nakon operacije i što raniji funkcionalni
oporavak pacijenata.

Abstract

Laparoscopic cholecystectomy is one of the most common minimally invasive operations in abdominal surgery and the
gold standard in the treatment of symptomatic gallbladder diseases. Although it is a minimally invasive technique, the
intensity of pain in the postoperative period can be significant, especially during the first 24 hours after surgery. Coping
with this pain can be approached by traditional treatment with different classes of analgesics or by the use of multimodal
analgesia, which includes their combination with regional anesthesia techniques. The most commonly used technique of
regional anesthesia in laparoscopic cholecystectomy operations is the block of the transverse abdominal plane (TAP block).
The TAP block is an ultrasound-guided local anesthetic injection technique in the plane between the internal oblique and
transverse abdominal muscles, which leads to the involvement of the sensory nerves that innervate the anterior abdominal
wall, thus achieving adequate perioperative pain control. The application of the TAP block dates back to the beginning of
the 21st century, and since then it has been the subject of numerous studies that have dealt with the impact of the TAP
block on the reduction of intraoperative opioid consumption, the intensity of postoperative pain, as well as on the reduction
of the frequency of side effects caused by opioid analgesics. Due to its simple execution and great efficiency, the TAP block
is used today as an analgesia strategy in numerous abdominal surgeries.

Keywords: laparoscopic cholecystectomy, TAP block, postoperative pain

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56 DOI: 10.5937/Galmed2411048D