Effectiveness of Various Post-Operative Pain Management Modalities Among Patients Undergoing Laparoscopic Surgery an Observational Study

Abstract

Postoperative pain remains a clinical challenge even after minimally invasive laparoscopic surgery, delaying recovery, prolonging hospital stay, and reducing patient satisfaction, and comparative real-world evidence on analgesic modalities is limited. This prospective observational study was conducted at SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India, from February 2025 to February 2026. A total of 272 adults undergoing laparoscopic surgery were categorised by the analgesic modality received: multimodal intravenous (IV) analgesia (n = 71), port site infiltration (PSI; n = 134), or transversus abdominis plane (TAP) block (n = 67). Postoperative pain over 24 hours (least, worst, and overall) was assessed with the Visual Analogue Scale (VAS), and patient satisfaction with the ASSIST questionnaire. Data were analysed using the Kruskal-Wallis test, Dunn's post-hoc test with Bonferroni correction, Pearson's Chi-square test, and Spearman's correlation coefficient; p < 0.05 was considered significant. The TAP block group had significantly lower pain scores than the multimodal IV and PSI groups. Least pain scores were lower with TAP block (median 1.0, IQR 1–2) than with multimodal IV (3.0, IQR 2–3) and PSI (2.0, IQR 1–3) (p < 0.001). Patient satisfaction was significantly higher with TAP block (median 8.0) than in the other groups (p < 0.001), and pain scores were inversely correlated with satisfaction. TAP block provides superior postoperative analgesia and higher patient satisfaction than multimodal IV analgesia and PSI in patients undergoing laparoscopic surgery, and incorporating it into multimodal analgesic protocols may improve postoperative recovery and outcomes.