Postoperative Analgesic Effect of Ultrasonography-guided Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy: Comparison with Local Wound Infiltration / 中国医科大学学报

ABSTRACT

Objective To compare the postoperative analgesic effect of ultrasonography-guided transversus abdominis plane (TAP) block and local wound infiltration in laparoscopic cholecystectomy (LC).Methods Fifty patients who underwent LC were randomly assigned to receive TAP block (T group) or local wound infiltration (A group).In group T,40 mL of 0.25％ mpivacaine was administered in TAP block.In group A,0.5％ ropivacaine was injected around the trocar and extraction site.Mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline,before incision,and 3 min after pneumoperitoneum.The dosages of remifentanil and sufentanil and the incidence of postoperative nausea and vomiting (PONV) were also recorded.Visual analogue scale (VAS) scores for resting and coughing states were assessed at 0,1,2,6,and 24 hours after operation.Results Compared with group A,the dosage of remifentanil was less,and MAP and HR at 3 min after pneumoperitoneum were significantly lower in group T (P ＜ 0.05).No significant difference was found in VAS score at resting state.In group T,the VAS scores at coughing state in the postanesthesia care unit immediately,1 h,and 2 h after operation were lower than those in group A (P ＜ 0.05).The sufentanil dosage was less in group T than in group A (P ＜ 0.05).No significant difference was found in the incidence of PONV.Conclusion The postoperative analgesic effect of TAP block is the same as that in local wound infiltration.However,it can reduce the pain score in the movement state and reduce the opioid dosages.