Application of ultrasound-guided subcostal transversus abdominis plane block in gastric cancer patients undergoing open gastrectomy

Background: To observe intraoperative and postoperative analgesic effect of ultrasound-guided subcostal transversus abdominis plane (TAP) block in gastric cancer patients undergoing open gastrectomy. Material and Methods: Forty patients with gastric cancer underwent open gastrectomy were randomly assigned into groups R and S. All patients received ultrasound-guided subcostal bilateral TAP under general anesthesia, and then were injected with 40 ml of 0.375% ropivacaine (group R) or equivalent amount of normal saline (group S). The surgery was performed in 30 min following the blocking. Intraoperatively, BIS value was maintained between 45 and 65. Patient-controlled intravenous analgesia pump was properly connected after the operation. Intraoperative changes in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were observed and the dosage of sufentanil and alternative drugs was closely monitored during the surgery. Visual analogue scale (VAS) scores and related surgical complications were recorded at 2, 4, 6, 12, 24 and 48 h following the operation. Results: The SBP, DBP and HR changes in the group R were significantly decreased compared with those in the group S (all P<0.01). In both groups, desirable analgesic effect was obtained. The VAS scores at postoperative 2, 4, 6 and 12 h after the surgery in the group R were significantly lower than those in the group S (all P<0.05). No TAP puncture-induced adverse reaction was observed in both groups. Conclusion: Ultrasound-guided subcostal transversus abdominis plane block has the advantages of accurate localization and high success rate. Clinical application of this technique in open gastrectomy can significantly decrease intraoperative and postoperative dosage of analgesics and exert desirable analgesic effect.