Introduction/Background TAP block has been used regularly as part of multimodal analgesia for cesarean and lower abdominal surgeries. In this study, we are comparing the analgesic efficacy of laparoscopic-guided TAP block with port infiltration in patients undergoing robotic assisted surgery for gynecologic malignancies.

Methodology This was a single institutional prospective double-blind randomized control trial. Approval was obtained from the hospital ethics committee and Clinical Trial Registry of India. 40 consecutive patients undergoing robotic-assisted surgery for gynecologic malignancy under general anaesthesia were included. Randomisation done by closed envelope technique. First group received bilateral TAP block (Group A) under direct laparoscopic vision with 15 cc of 0.1% ropivacaine on each side. Second group (Group B)received routine port site infiltration with 30 ml of 0.1% ropivacaine. Parameters measured were numeric pain score till 24 hours after surgery, post operative nausea and vomiting, mean arterial pressure (MAP), need for rescue analgesic and time to ambulation, first feed, discharge from recovery and hospital. Chi square test or Fischer’s exact test were performed to compare categorical variable. To analyze quantitative data, student t test was used.

Results The pain scores were significantly lower for Group A (figure 1). The use of rescue Analgesic was also less in group A compared to Group B (15% vs 90% respectively)with the difference being significant (p<0.001). No complications were noted at the site of injection (Bleeding/haematoma). There was no difference in MAP, Post operative nausea and vomiting, time to ambulation, first feed and also discharge from recovery and hospital.

Conclusion Laparoscopic guided TAP block for patients undergoing robotic assisted surgery for gynecologic malignancies is effective in reducing post operative pain as shown by the reduced pain scores and decreased need for rescue analgesics. There were no increased complications due to the procedure

Disclosure Nothing to disclose.