Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy
Yükleniyor...
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier Science Inc
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective: To evaluate and compare intercostal-iliac transversus abdominis plane (TAP) and oblique sub costal TAP (OSTAP) blocks for multimodal analgesia in patients receiving laparoscopic cholecystectomy. Design: A prospective, randomized, double-blinded clinical study. Setting: Operating room, postoperative recovery area, and ward. Patients: In total, 60 laparoscopic cholecystectomy patients (43 women, 17 men, American Society of Anesthesiologists grades I-II) were enrolled from the general surgery department of our tertiary care center. Intervention: The patients were assigned to 1 of the 3 groups. Group 1 received TAP blocks (n = 20), group 2 received OSTAP blocks (n = 20), and group 3 patients were used as controls and received patient-controlled analgesia (PCA) only (n = 20). After the induction of anesthesia, blocks were performed bilaterally in study groups 1 and 2, using 20 mL of lidocaine (5 mg/mL). PCA with intravenous tramadol was routinely provided for all patients during the first 24 hours. Measurements: The intraoperative use of remifentanil, postoperative visual analog scale (VAS) scores, demand for PCA, and total analgesic consumption were recorded. Main Results: The patients in the control group had greater analgesic demands and analgesic consumption than did those in groups 1 and 2. However, patients in the OSTAP group had lower VAS scores than did those in groups 1 and 3. Results: The demand for analgesia was greater in the control group than in groups 1 and 2. Moreover, lower VAS scores were recorded in the OSTAP group than in groups 1 and 3 and were positively correlated with total PCA consumption among all patients. However, postoperative VAS scores were negatively correlated with the total intraoperative consumption of remifentanil at 24 hours. Conclusions: TAP and OSTAP blocks improved postoperative analgesia in patients receiving laparoscopic cholecystectomy, which resulted in lower VAS scores and reduction in total analgesic consumption. (C) 2016 Elsevier Inc. All rights reserved.
Açıklama
Anahtar Kelimeler
Laparoscopic cholecystectomy, Oblique subcostal transversus abdominis plane block, Transversus abdominis plane block
Kaynak
Journal of Clinical Anesthesia
WoS Q Değeri
Q3
Scopus Q Değeri
Q1
Cilt
34
