B340 The combination of ultrasound-guided rectus sheath block with right subcostal transversus abdominis plane block in laparoscopic cholecystectomy

Abstract

<h3>Background and Aims</h3> We aimed to retrospectively study the efficacy of ultrasound guided rectus sheath block (RSB) in combination with right subcostal transversus abdominis plane block (TAP) for laparoscopic cholecystectomy as an effective intra and postoperative analgesic method. <h3>Methods</h3> We studied 20 patient files, operated for laparoscopic cholecystectomy. All patients meeting the criteria were operated under general anesthesia using propofol, fentanyl and rocuronium. Following anesthesia induction, a bilateral RSB using 15 ml ropivacaine 0.375% on each side and a right subcostal TAP block using 20 ml ropivacaine 0.375% were performed. Intraoperative fentanyl dose was 2 mcg/kg for all patients. We evaluated all recorded numerical rating scores (NRS) charted, immediately postoperatively and 6 and 24 hours later. In addition, complaints of nausea, vomiting and constipation were recorded. <h3>Results</h3> Intraoperative arterial blood pressure and cardiac rhythm trends, suggested stable hemodynamics and reflected effective analgesia in all cases. Median NRS scores immediately postoperatively were up to 1.5 and up to 3 in all following recording instances with no additional analgesics required, besides paracetamol that was administered every 8 hours. Nausea and vomiting was absent for all these patients and only 4 patients reported constipation over 3 days. <h3>Conclusions</h3> Ultrasound guided combination of RSB with right subcostal TAP block is an effective and safe intra and postoperative analgesic method.