Discussion
cough, Carney et alThe dual block, thoracolumbar, pain
INFILTRATION
The results of this study comparing the efficacy of 4 different techniques in the management of post-LC pain demonstrated that the BLTAP block was more effective in preventing postoperative 1-hour pain compared to standard IV analgesia, port-site infiltration of local anesthetic, and the ULTAP block. However, there was no difference in the pain values measured subsequently and the use of rescue analgesics among the 4 techniques.The efficacy of the LTAP block has been investigated using different surgical procedures. Field et alOur study demonstrated that the BLTAP block was more effective in reducing postoperative 1-hour pain scores both during rest and cough compared to conventional IV analgesia and ULTAP block in LC cases. However, the BLTAP block had no difference with the other techniques in terms of opioid requirement for pain. Our study is similar to that of Elamin et alSeveral studies have shown that local anesthetic agents have a more limited spread in isolated lateral and subcostal blocks; therefore, both sites should be blocked for complete and long-term blockade of the T6-L1 thoracolumbar nerves. The study of Carney et alThe dual block technically combines the lateral/posterior TAP block with the subcostal approach, producing a block that involves both the upper and lower abdomen. It was first carried out by Borglum et alAnother controversial issue is the type of anesthetic agent induced. Liposomal bupivacaine has been indicated to be longer-acting and more effective. It is a relatively new agent, which is not always easily accessible. The addition of dexamethasone is another approach. Although several studies have shown that the efficacy of both procedures is extended, the results remain controversial.