Research on combination of general anesthesia and ultrasound-guided oblique subcostal transversus abdominis plane block with different concentration of ropivacaine for upper abdominal surgery
10.12089/jca.2018.02.011
- VernacularTitle:超声引导下不同浓度罗哌卡因肋缘下入路腹横肌平面阻滞在上腹部手术中的效果
- Author:
Yuanqiang DAI
1
;
Pingshan WEN
;
Jun CHEN
;
Ningyu DAI
;
Yu MA
;
Tao XU
Author Information
1. 第二军医大学附属长海医院麻醉学部临床麻醉科
- Keywords:
Ropivacaine;
Ultrasound-guided transversus abdominis plane block;
Combined anesthesia
- From:
The Journal of Clinical Anesthesiology
2018;34(2):149-152
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of ultrasound-guided oblique subcostal trans versus abdominis plane (OSTAP) block with different concentration of ropivacaine in combined anesthesia for upper abdominal surgery.Methods One hundred forty-seven patients underwent upper abdominal surgery,85 males and 62 females,aged 18-80 years,ASA physical status Ⅰ or Ⅱ,were recruited and randomly divided into four groups.Bilateral ultrasound-guided OSTAP block were performed in each group.Ropivacaine hydrochloride injection of 2.5 mg/kg were performed in each of group A (n =41),B (n =55),C (n =37) while concentration was 0.375％,0.5％,0.75％,respectively.Group D (n =14) was received 20 ml of saline solution for each side.Intravenous-inhalation combined anesthesia was conducted during the surgery,with sevoflurane 0.8-1.0 MAC,dexmedetomidine 0.5 μg/kg iv,remifentanil 0.1μg·kg-1 ·min-1 iv.Each group was received patient-controlled intravenous analgesia (PCIA) after surgery which contained butorphanol tartrate and flurbiprofen axetil.The consumption of opioids and vasoactive drugs,hemodynamic parameters in operation were recorded.The visual analogue scale (VAS) scores were evaluated at 12 and 24 h after operation,the location and degree of abdominal pain,fentanyl used for acute pain during the first 12 h after operation,the postoperative intestinal exhaust time and hospitalization time were also recorded.Results There was no difference in basic states,duration of operation or blood loss in each group.The consumption of sufentanil in operation in groups A,B and C was (30.5±9.4)μg,(27.4±7.4) μg,(30.9±8.8) μg,respectively,which were significantly lower than that in group D [(47.1±9.3) μg] (P＜0.05).There was no difference in vasoactive drugs between the four groups.There was no difference in hemodynamic indexes in the TAP block groups.There was no significant difference in intraoperative blood loss between the four groups the VAS scores.There was no difference in the location and degree of abdominal pain,fentanyl used for acute pain,the postoperative intestinal exhaust time and hospitalization time.Conclusion Intraoperative opioids consumption in combined general anesthesia was reduced by ultrasound-guided OSTAP block.There is no difference between the effect of OSTAP block with different concentration of ropivacaine in combined anesthesia for upper abdominal surgery.
