The Postoperative Analgesic Effect of Ultrasound-Guided Bilateral Transversus Abdominis Plane Combined with Rectus Sheath Blocks in Laparoscopic Hepatectomy: A Randomized Controlled Study

被引:4
|
作者
Lu, Xiaoyun [1 ,2 ]
Yu, Ping [1 ,2 ]
Ou, Chaopeng [1 ,2 ]
Wang, Junchao [1 ,2 ]
Zhou, Zhongguo [1 ,3 ]
Lai, Renchun [1 ,2 ]
机构
[1] Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Canc Ctr, Guangzhou, Guangdong, Peoples R China
[2] Sun Yat Sen Univ, Dept Anesthesiol, Canc Ctr, Guangzhou, Guangdong, Peoples R China
[3] Sun Yat Sen Univ, Dept Liver Surg, Canc Ctr, Guangzhou, Guangdong, Peoples R China
关键词
laparoscopic hepatectomy; analgesia; transversus abdominis plane block; rectus sheath block; ultrasound; SURGERY; PAIN; CHOLECYSTECTOMY; PATTERNS; OUTCOMES; TERM;
D O I
10.2147/TCRM.S267735
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Our aim was to investigate the postoperative analgesic effect of ultrasound (US)-guided bilateral transversus abdominis plane (TAP) blocks combined with rectus sheath blocks (RSBs) in laparoscopic hepatectomy. Patients and Methods: A total of 126 patients were allocated into two groups for analysis. Group 1 (n = 63) did not receive any local anesthetics. Group 2 (n = 63) received US -guided bilateral TAP blocks and RSBs using 20 mL 0.25% ropivacaine in each block. Postoperative pain scores, the dose of intraoperative remifentanil, 24 h consumption of oxycodone, adverse events such as postoperative dizziness, nausea and vomiting, and the length of postoperative hospital stay were recorded. Results: In the postanesthesia care unit, patients in group 2 had significantly lower pain visual analog scale (VAS) scores at rest than those in group 1 (P < 0.001). The VAS scores both at rest and during movement were significantly lower in group 2 than in group 1 at 2, 4 and 6 h postoperatively (all P < 0.001). There was no difference in VAS scores between the two groups at rest 24 h postoperatively (P = 0.477). However, the VAS score during movement at 24 h in group 2 was significantly lower than that in group 1 (P < 0.001). No significant differences in the incidence of adverse events or the dose of intraoperative remifentanil were observed between the two groups (all P > 0.05). Patients in group 2 had a significantly lower 24 h consumption of oxycodone than patients in group 1 (P < 0.001). The mean length of postoperative hospital stay of group 2 was shorter than that of group 1 (P = 0.032). Conclusion: US-guided bilateral TAP blocks combined with RSBs provide effective postoperative analgesia for laparoscopic hepatectomy, and they could shorten the postoperative hospital stay without increasing the incidence of adverse events from opioids.
引用
收藏
页码:881 / 888
页数:8
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