Efficacy of ultrasound-guided transversus abdominal plane and posterior rectus sheath block for postoperative analgesia in patients undergoing radical resection for gastric cancer

Abstract

Objective To evaluate the efficacy of ultrasound-guided transversus abdominal plane (TAP) and posterior rectus sheath (PRS) block for postoperative analgesia in the patients undergoing radical resection for gastric cancer. Methods One hundred twenty patients of both sexes, aged 18-64 yr, with body mass index of 19-25 kg/m2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective radical resection for gastric cancer, were divided into 2 groups (n=60 each) using a random number table: control group (group C) and ultrasound-guided TAP and PRS block group (group T+ R). Bilateral TAP (0.375% ropivacaine 0.5 ml/kg was injected) and PRS block (0.375% ropivacaine 0.3 ml/kg was injected) were performed before induction of general anesthesia in group T+ R.Patient-controlled intravenous analgesia was provided to all the patients after surgery in the two groups, and the visual analog scale score at rest and during activity was maintained less than 4 within 48 h after surgery.The requirement for rescue analgesia within 48 h after surgery and occurrence of adverse reactions during the analgesia period were recorded. Results Compared with group C, the requirement for rescue analgesia within 48 h after surgery and incidence of nausea and vomiting were significantly decreased in group T+ R (P<0.05). Conclusion Ultrasound-guided TAP and PRS block provides better efficacy for postoperative analgesia with less adverse reactions in the patients undergoing radical resection for gastric cancer. Key words: Ultrasonography; Abdominal muscles; Nerve block; Analgesia; Stomach neoplasms