Efficacy of preoperative transversus abdominis plane block for improving analgesia after radical resection of colorectal cancer in elderly patients / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of preoperative transversus abdominis plane (TAP) block for improving analgesia after radical resection of colorectal cancer in elderly patients.Methods Fiftysix American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 75-86 yr,weighing 52-78 kg,scheduled for elective radical resection of colorectal cancer under general anesthesia,were divided into 2 groups (n=28 each) using a random number tableTAP block group (group T) and control group (group C).After anesthesia induction,ultrasound-guided bilateral TAP block was performed,and 0.40％ ropivacaine 25 ml was injected into each side in group T.Both groups received patientcontrolled intravenous analgesia (PCIA) with fentanyl after surgery.PCIA solution contained fentanyl 600 μg and azasetron 10 mg in 100 ml of normal saline.The PCIA pump was set up with a 2 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h,and visual analogue scale score was maintained≤ 3.When the visual analogue scale score＞3,tramadol 50-100 mg was intravenously injected as rescue analgesic.The number of patients requiring rescue analgesic,consumption of fentanyl during PCIA and the number of successfully delivered doses were recorded within 24 h after surgery.The adverse reactions such as hematoma at the puncture site,nausea and vomiting,respiratory depression,chest tightness and pruritus were recorded.Results Compared with group C,the number of patients requiring rescue analgesic was significantly decreased,and the consumption of fentanyl and the number of successfully delivered doses during PCIA were decreased in group T (P＜0.05).No hematoma was found at the puncture site in group T.No respiratory depression,chest tightness or pruritus was found in the two groups,and there were no significant differences in the incidence of nausea and vomiting between the two groups (P＞0.05).Conclusion Preoperative TAP block can reduce the consumption of fentanyl and enhance the efficacy of analgesia after radical resection of colorectal cancer in elderly patients.