The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair.

Autor: Kartalov A; Clinic for Anesthesiology, Reanimatology and Intensive Care Unit - KARIL, Skopje, Republic of Macedonia., Jankulovski N; Clinic for Abdominal surgery, Skopje, Republic of Macedonia., Kuzmanovska B; Clinic for Anesthesiology, Reanimatology and Intensive Care Unit - KARIL, Skopje, Republic of Macedonia., Zdravkovska M; Faculty of Medical Sciences, 'Goce Delchev University', Shtip, Republic of Macedonia., Shosholcheva M; Clinic for Anesthesiology, Reanimatology and Intensive Care Unit - KARIL, Skopje, Republic of Macedonia., Tolevska M; Clinic for Anesthesiology, Reanimatology and Intensive Care Unit - KARIL, Skopje, Republic of Macedonia., Naumovski F; Clinic for Anesthesiology, Reanimatology and Intensive Care Unit - KARIL, Skopje, Republic of Macedonia., Srceva M; Clinic for Anesthesiology, Reanimatology and Intensive Care Unit - KARIL, Skopje, Republic of Macedonia., Petrusheva AP; Clinic for Anesthesiology, Reanimatology and Intensive Care Unit - KARIL, Skopje, Republic of Macedonia., Selmani R; Clinic for Abdominal surgery, Skopje, Republic of Macedonia., Sivevski A; University Clinic for Genecology and Obstetric, Skopje, Republic of Macedonia.
Jazyk: angličtina
Zdroj: Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) [Pril (Makedon Akad Nauk Umet Odd Med Nauki)] 2017 Dec 01; Vol. 38 (3), pp. 135-142.
DOI: 10.2478/prilozi-2018-0014
Abstrakt: Background: Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair.
Methods: After the hospital ethics committee approval, 60 (ASA I-II) adult patients scheduled for umbilical hernia repair were included in this study. The group I (n=30) patents received only general anesthesia. In the group II (n = 30) patents after induction of general anesthesia received a bilateral ultrasound guided rectus sheath block with 40 ml of 0.25% bupivacaine. In this study we assessed demographic and clinical characteristics, pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after operation and total analgesic consumption of morphine dose over 24-hours.
Results: There were statistically significant differences in VAS scores between the groups I and II at all postoperative time points - 2hr, 4 hr, 6 hr, 12 hr and 24 hr. (P < 0.00001). The cumulative 24 hours morphine consumption after the operation was significantly lower in the group II (mean = 3.73 ± 1. 41) than the group I (mean = 8.76 ± 2.41). This difference was statistically significant (p = 0.00076).
Conclusion: The ultrasound guided rectus sheath block used for umbilical hernia repair could reduce postoperative pain scores and the amount of morphine consumption in 24 hours postoperative period.
Databáze: MEDLINE
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