Efficacy of ultrasound-guided transversus abdominis plane (TAP) block for preventive analgesia in patients underwent gynecological laparoscopy
10.3969/j.issn.1007-1989.2018.03.016
- VernacularTitle:超声引导下腹横肌平面阻滞对于妇科腹腔镜手术患者预防性镇痛的效果
- Author:
Chun-Lian ZHOU
1
;
Yan-Qing YANG
;
Xiao-Dan WANG
Author Information
1. 台州恩泽医疗中心(集团)恩泽医院 麻醉科
- Keywords:
transversus abdominis plane block;
ultrasound-guided;
gynecological laparoscopy;
analgesia
- From:
China Journal of Endoscopy
2018;24(3):75-79
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of ultrasound-guided transversus abdominis plane (TAP) block for preventive analgesia in patients undergoing gynecological laparoscopy. Methods 60 ASA physical status I ~ II, aged 30 ~ 50 yr, weighting 50 ~ 65 kg patients scheduled for elective gynecological laparoscopy were randomly divided into 3 groups using a random number table (n = 20 each): control group (group I), preoperative TAP block group (group II) and postoperative TAP block group (group III). Ultrasound-guided bilateral TAP block was performed before induction of anesthesia or at the end of surgery in II and III groups, respectively. Patient-controlled intravenous analgesia (PCIA) with 1μg/ml sufentanil (background infusion 2 ml/h, bolus dose 2 ml, lockout interval 15 min) was used until 2 days after surgery and VAS score was maintained ≤ 3. When VAS score > 3, flurbiprofen axetil 50 mg was injected intravenously as rescue medication. The consumption of sufentanil per hour, requirement for rescue medication, and development of adverse reactions were recorded within 24 h after surgery. Sufentanil-sparing degree was calculated. Results Compared with group I, the consumption of sufentanil per hour, requirement for rescue medication and the incidence of nausea and vomiting were significantly lower within 24 h after surgery in II and III groups (P < 0.05). The consumption of sufentanil per hour, requirement for rescue medication and the incidence of nausea and vomiting were significantly lower in group II than in group III (P < 0.05). The consumption of sufentanil was decreased by 35.0% in group II as compared with group I, and decreased by 16.0% in group II as compared with group III. Conclusion Ultrasound-guided TAP block can provide good postoperative analgesia in patients undergoing gynecological laparoscopy, and effect of preoperative nerve block is better than that of postoperative nerve block.
