Comparison of transverse abdominis plane block and deep wound local anesthesia in postoperative analgesia for kidney transplant recipients
10.3760/cma.j.cn115396-20230715-00197
- VernacularTitle:腹横肌平面阻滞与伤口深部肌层局麻在肾移植受者术后镇痛中的对比研究
- Author:
Qipei LI
1
;
Xiaoming LIU
;
Chunkai DU
;
Jian ZHANG
;
Chen ZHU
Author Information
1. 首都医科大学附属北京友谊医院麻醉科，北京 100050
- Keywords:
Kidney transplantation;
Analgesia;
Anesthesia, general;
Transversus abdominis plane block;
Local anesthesia
- From:
International Journal of Surgery
2023;50(10):664-669
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of preoperative transversus abdominis plane block (TAPB) and intraoperative deep wound local anesthesia on improving postoperative pain in kidney transplant recipients.Methods:A retrospective study was conducted on 62 recipients who underwent allogeneic kidney transplantation at Beijing Friendship Hospital, Capital Medical University from January 2020 to June 2023. The recipients were divided into three groups according to the different methods of postoperative analgesia: group A ( n=11), group B ( n=28) and group C ( n=23). Group A received preoperative TAPB anesthesia, group B received intraoperative deep wound local anesthesia, and group C received conventional anesthesia. Demographic characteristics, intraoperative parameters, postoperative pain visual analog scale (VAS) scores at 0, 2, 12 and 24 hours, postoperative analgesic medication requirement, time to postoperative oral intake, and incidence of complications were compared among the three groups. The normality of measurement data was tested by Shapiro-Wilk method. Measurement data conforming to normal distribution were expressed as mean ± standard deviation ( ± s). ANOVA was used for comparison between groups, and S-N-K method was used for pairwise comparison between groups with differences. Measurement data that did not conform to the normal distribution were expressed as the median (interquartile distance) [ M( Q1, Q3)], Kruskal-Wallis H test was used for comparison between groups, and Bonferroni was used for pairwise comparison after the fact if there were differences between groups. The Chi-square test or Fisher exact probability method was used for comparison between data groups. Results:There were no significant differences in demographic characteristics and intraoperative parameters among the three groups ( P>0.05). The pain VAS scores at 0, 2, 12 and 24 h after surgery in group A and group B were significantly lower than those in group C ( P<0.001), and the pain VSA scores at 0 and 24 h were no difference between group A and group B, while the pain VAS scores at 2 and 12 h were lower in group A than those in group B. The postoperative analgesic medication requirement was also significantly lower in group A and group B than those in group C, the requirement rate of nonsteroidal antiinflammatory drug in group A was lower than that in group B. Moreover, the time to postoperative oral intake was significantly shorter in group A and group B compared to group C. These differences were statistically significant ( P< 0.05). There were no statistically significant differences in postoperative nausea and vomiting or major complications among the three groups ( P> 0.05). Conclusions:Preoperative TAPB and intraoperative deep wound local anesthesia can effectively alleviate postoperative pain in kidney transplant recipients, reduce the use of analgesic medication, promote early recovery of gastrointestinal function in donors, and do not increase the incidence of postoperative complications. The analgesic effect of deep wound local anesthesia was similar to preoperative TAPB.
