Postoperative analgesic effect of transversus abdominis plane block in the anesthesia of open intestinal surgeries

Abstract

Objective To evaluate the postoperative analgesic effect of transversus abdominis plane block(TAPB) under guidance of ultrasonic in the anesthesia of intestinal surgeries on intestinal tumor patients. Methods Eighty patients undergoing intestinal tumors with lateral rectus incision, American Society of Anesthesiologists(ASA)Ⅰ-Ⅲ were randomly devided into two groups: group TAPB(group T, n=40) and group control (group C, n=40). After induction of general anesthesia, anesthesia was maintained with sevoflurane to keep the Bispectral Index(BIS) value within 40-60. In group T, one side TAPB was performed under ultrasound guidance. In group C, 10 μg sufentanil was given both at the time point of incision and before peritoneal closure. Numerical Rating Scale(NRS) pain scores, pressing times of patient-controlled infusion analgesia (PCIA), postoperative nausea and vomiting(PONV) scores were recorded at designed time points postoperative [post-anesthesia care unit(PACU), 2, 6, 12, 24 h]. Results NRS scores in group T were lower than those in group C at postoperative PACU (0 vs 2.9±1.1), postoperative 2 h (0 vs 3.1±0.7), postoperative 6 h (1.2±0.5 vs 3.7±0.9, P<0.05). Cumulative pressing times of PCIA in group T were less than those in group C at postoperative PACU (0 vs 1.1±0.7), postoperative 2 h (0.5±0.9 vs 2.0±1.2), postoperative 6 h (1.7±1.1 vs 4.5±2.3), postoperative 12 h (4.5±2.2 vs 8.5±3.3) and postoperative 24 h (8.1±3.3 vs 12.8±3.1, P<0.05). PONV scores in group T were significantly lower than those in group C at postoperative PACU (0 vs 2.1±0.9), postoperative 2 h (0 vs 1.7±0.8), postoperative 6 h (0 vs 2.2±0.6), postoperative 12 h (0.9±0.6 vs 2.2±0.7) and postoperative 24 h (0 vs 2.1±0.9, P<0.05). Conclusions TAPB could provide better analgesia effect, reduce postoperative dosage of opioids and the PONV scores. Key words: Transversus abdominis plane block; Intestinal cancer; Incision pain