ABSTRACT
Objective To evaluate the efficacy of ultrasound-guided transversus abdominal plane (TAP) and posterior rectus sheath (PRS) block for postoperative analgesia in the patients undergoing radical resection for gastric cancer.Methods One hundred twenty patients of both sexes,aged 18-64 yr,with body mass index of 19-25 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective radical resection for gastric cancer,were divided into 2 groups (n =60 each) using a random number table:control group (group C) and ultrasound-guided TAP and PRS block group (group T+R).Bilateral TAP (0.375％ ropivacaine 0.5 ml/kg was injected) and PRS block (0.375％ ropivacaine 0.3 ml/kg was injected) were performed before induction of general anesthesia in group T+R.Patient-controlled intravenous analgesia was provided to all the patients after surgery in the two groups,and the visual analog scale score at rest and during activity was maintained less than 4 within 48 h after surgery.The requirement for rescue analgesia within 48 h after surgery and occurrence of adverse reactions during the analgesia period were recorded.Results Compared with group C,the requirement for rescue analgesia within 48 h after surgery and incidence of nausea and vomiting were significantly decreased in group T+R (P＜0.05).Conclusion Ultrasound-guided TAP and PRS block provides better efficacy for postoperative analgesia with less adverse reactions in the patients undergoing radical resection for gastric cancer.
ABSTRACT
Objective To evaluate the efficacy and safety of bilateral transversus abdominis plane block (TAPB)combined with bilateral rectus sheath block (RSB)in abdominal surgery. Methods Ninety ASA Ⅰ or Ⅱ patients,35 males,55 females,aged 19-79 years,with body mass index 18-30 kg/m2 ,scheduled for elective laparoscopic cholecystectomy were randomly divided into three groups(n=30):ultrasound-guided bilateral TAPB combined with bilateral RSB group (group TR),ultrasound-guided bilateral TAPB group (group T),patient-controlled intravenous analgesia (PCIA)group (group P).In group TR,ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were per-formed with 10 ml of 0.22% ropivacaine mesylate injection in each side before surgery.In group T, ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery.In group P,ultrasound-guided bilateral TAPB were performed with 20 ml of NS in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery, and PCIA was applied in group P.BP,HR,SpO2 were observed when patients were sent into the op-erating room, 2 minutes before trocar puncture, and 2 minutes after trocar puncture, the consumption of propofol and remifentanil used during the surgery were recorded.The score of visual analogue scale (VAS)during rest and movement were recorded at 2,6,12,24 h after surgery.The patient analgesia satisfaction and the adverse reactions were recorded.Results Compared with group T and group P,group TR had less change of BP before and after trocar puncture(P <0.05).The VAS score was significantly lower in group TR after operation(P <0.05).There were no statistical significant differences of VAS score at 24 h after operation among the three groups.The patient anal-gesia satisfaction was significantly better in group TR than other two groups (P < 0.05 ). Conclusion Ultrasound-guided bilateral transversus abdominis plane block combined with bilateral rectus sheath block is of safety and much efficacy of postoperative analgesia in patients undergoing laparoscopic cholecystectomy.