Laparoscopic-assisted transversus abdominis plane block versus port-site infiltration in appendicectomy: multicentre randomized clinical trial

Daly, GR; Dowling, GP; Hembrecht, S; O'Grady, S; Hegarty, A; Roche, T; Orsi, G; Pierre, A; Calpin, GG; Neary, C; Hehir, CM; Hill, GJ; O'Brien, A; Duggan, WP; Davey, MG; Stephens, IJB; Kennedy, ND; Brennan, O; Hayes, C; Al Azzawi, M; Balasubramanian, I; McGuire, A; Zaborowski, AM; Reynolds, IS; Loughlin, P; Allen, M; Power, C; Butt, A; Boland, MR; McCawley, N; Burke, JP; Robb, WB; Mastrosimone, A; Arumugasamy, M; Prins, H; Beddy, D; Kerin, MJ; McNamara, DA; Kearney, D; Sorensen, J; Curley, GF; Abd El Wahab, S; Hill, ADK

doi:10.1093/bjs/znaf257

Regional anaesthesia

Laparoscopic-assisted transversus abdominis plane block versus port-site infiltration in appendicectomy: multicentre randomized clinical trial

Br J SurgPublished 9 Jan 2026Randomised controlled trial

Primary result · VAS pain score, time-weighted analysisResultDifference −1.7 95% CI −2.06 to −1.34

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Authors' conclusion

LTAP block significantly improved early postoperative analgesia outcomes in patients undergoing laparoscopic appendicectomy

Study context

Population: Patients undergoing laparoscopic appendicectomy, three academic hospitals85/87 LTAP, 82/84 port-site infiltration (PSI) analysed
Participants: 87 vs 84

Comparison: LTAP block vs PSI of local anaesthetic
LTAPn = 87
PSIn = 84reference
Primary endpoint: Postoperative pain (VAS)

Methodological detailssingle-blinded, multicentre

Single-blinded
Multicentre

Primary result

VAS pain score, time-weighted analysis

Difference

−1.7

95% CI −2.06 to −1.34

P < 0.001

LTAP vs PSI

difference −1.7 (95% CI −2.06 to −1.34); P < 0.001

As reported in the abstract

Secondary outcomes

Outcome	← Lower with LTAP ←→ Higher with LTAP →	Difference-in-difference (95% CI)	P value
VAS pain score, difference-in-difference analysis (LTAP) · 6 h, 12 h, 24 hLTAP vs PSI · 6 h	−4−202	−1.63 (−2.55 to −0.70)	P = 0.001
VAS pain score, difference-in-difference analysis (LTAP) · 6 h, 12 h, 24 hLTAP vs PSI · 12 h	−4−202	−2.06 (−2.92 to −1.20)	P < 0.001
VAS pain score, difference-in-difference analysis (LTAP) · 6 h, 12 h, 24 hLTAP vs PSI · 24 h; no difference	−4−202	−0.68 (−1.55 to 0.19)	P = 0.125
	−4−202Difference (linear scale)

Visual analogue scale (VAS) pain score, difference-in-difference analysis (LTAP) — PSI at 6 h: 3.72 (95% c.i. 3.27 to 4.17); P < 0.001
VAS pain score, difference-in-difference analysis (LTAP) — PSI at 12 h: 3.37 (95% c.i. 2.89 to 3.87); P < 0.011
VAS pain score, difference-in-difference analysis (LTAP) — PSI at 24 h: 1.57 (95% c.i. 1.13 to 2.01); P < 0.001

Oxycodone requirements

Significant reduction in the LTAP group (1.2 versus 0.8; P = 0.032)

Reference

Authors: Daly GR, Dowling GP, Hembrecht S, O'Grady S, Hegarty A, Roche T, et al.
All 43 authors
Daly GR, Dowling GP, Hembrecht S, O'Grady S, Hegarty A, Roche T, Orsi G, Pierre A, Calpin GG, Neary C, Hehir CM, Hill GJ, O'Brien A, Duggan WP, Davey MG, Stephens IJB, Kennedy ND, Brennan O, Hayes C, Al Azzawi M, Balasubramanian I, McGuire A, Zaborowski AM, Reynolds IS, Loughlin P, Allen M, Power C, Butt A, Boland MR, McCawley N, Burke JP, Robb WB, Mastrosimone A, Arumugasamy M, Prins H, Beddy D, Kerin MJ, McNamara DA, Kearney D, Sorensen J, Curley GF, Abd El Wahab S, Hill ADK
Journal: British Journal of Surgery
Published: 9 Jan 2026
DOI: 10.1093/bjs/znaf257
PubMed: 41511871
Registration: NCT05427266

Topic: Regional anaesthesia

Intervention details

LTAP: laparoscopic-assisted transversus abdominis plane block
PSI: port-site infiltration of local anaesthetic

Original publication

Laparoscopic-assisted transversus abdominis plane block versus port-site infiltration in appendicectomy: multicentre randomized clinical trial. Br J Surg. Published 9 January 2026. doi:10.1093/bjs/znaf257

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