Effect of transversus abdominis plane block with liposomal bupivacaine and general anesthesia on postoperative delirium in elderly patients with prior novel coronavirus pneumonia
10.3760/cma.j.cn131073-20240808-00706
- VernacularTitle:布比卡因脂质体TAPB联合全身麻醉对既往COVID-19老年患者POD的影响
- Author:
Yuanlong WANG
1
;
Dingwei LIU
;
Wenjie KONG
;
Shuhui HUA
;
Shanling XU
;
Jian KONG
;
Hongyan GONG
;
Rui DONG
;
Yanan LIN
;
Chuan LI
;
Yanlin BI
;
Bin WANG
;
Xu LIN
Author Information
1. 滨州医学院第二临床医学院，烟台 264003
- Publication Type:Journal Article
- Keywords:
Bupivacaine;
Liposomes;
Abdominal muscles;
Nerve block;
Delirium;
Postoperative complications;
COVID-19;
Aged
- From:
Chinese Journal of Anesthesiology
2025;45(7):812-817
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the effect of transversus abdominis plane block (TAPB) with liposomal bupivacaine and general anesthesia on postoperative delirium (POD) in elderly patients with prior novel coronavirus pneumonia (COVID-19).Methods:In this randomized double-blind controlled study, 416 patients of either sex, aged 65-90 yr, weighing 50-90 kg, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, diagnosed as having COVID-19 within 6 months prior to surgery, who underwent laparoscopic colorectal cancer surgery under combination of elective TAPB and combined intravenous-inhalational general anaesthesia at Qingdao Municipal Hospital from June 2023 to December 2024, were selected. The patients were divided into liposomal bupivacaine group ( n=208) and bupivacaine hydrochloride group ( n=208) using the random number table method. After induction of anaesthesia, bilateral TAPB was performed with liposomal bupivacaine injectio 266 mg (40 ml) in liposomal bupivacaine group and with 0.5% bupivacaine hydrochloride 40 ml in bupivacaine hydrochloride group. The primary outcome measure was the occurrence of POD within 7 days after surgery. Secondary outcome measures included severity of POD, pain scores at 24, 48 and 72 h after operation, the rate of postoperative rescue analgesia and consumption of morphine, duration of post-anesthesia care unit stay, and length of hospital stay. The occurrence of complications such as death, reoperation, atelectasis and pneumonia was recorded at 30 days after surgery. Results:Compared with bupivacaine hydrochloride group, the incidence of POD was significantly decreased (21.5% [43/200]versus 12.0% [24/200]), pain scores at 24, 48 and 72 h after operation were decreased, the rate of postoperative rescue analgesia and consumption of morphine were decreased, and the duration of post-anesthesia care unit stay and length of hospital stay were shortened in liposomal bupivacaine group ( P<0.05). There was no significant difference in the severity of POD and the case fatality rate and related complications within 30 days after surgery between the two groups ( P>0.05). Conclusions:Liposomal bupivacaine TAPB combined with general anesthesia can reduce the development of POD in elderly patients with prior COVID-19.
