Background Laparoscopic cholecystectomy (LC) is a common procedure for symptomatic gallstone disease, however postoperative pain, nausea, and vomiting remains a significant concern1. Local anaesthetic (LA) is commonly used to infiltrate the wounds created to assist with reduction of postoperative pain. Opioid analgesia is used as a common adjunct for post operative pain. This study considers whether Transversus abdominis pain (TAP) block in conjunction with rectus sheath (RS) blocks reduce the need for opioids post LC when compared to the infiltration of LA directly to the surgical incisions.

Methods A prospective block randomised controlled trial was performed on all patients who underwent emergency LC at the Gold Coast University Hospital (GCUH) between April 2022 and February 2023. Patients were allocated to receive either TAP and RS block or LA to laparoscopic port sites. Allocation was performed according to the patient's week of operation, weeks one and three TAP/RS blocks and week two and four port site LA. 40ml of ropivacaine 0.375% was used for port site infiltration and used for TAP and RS blocks. Post-operative opioid use, antiemetic use, and operative entry technique, duration of operation and length of stay (LOS) were recorded and analysed. Ethics approval was granted through the GCHHS Human Research Ethics Committee. [...]