Does ultrasound-guided transversus abdominis plane blockade decrease perioperative opioids in morbid obese patients undergoing laparoscopic surgery?

Autor:	Yevsieieva V; State Administrative Department, State Institution Of Science 'Research And Practical Center Of Preventive And Clinical Medicine', Kyiv, Ukraine, State Scientific Institution Center For Innovative Medical Technologies Of The National Academy Of Sciences Of Ukraine ,Kyiv, Ukraine., Perehrestenko A; State Scientific Institution Center For Innovative Medical Technologies Of The National Academy Of Sciences Of Ukraine ,Kyiv, Ukraine., Kozubovich R; State Scientific Institution Center For Innovative Medical Technologies Of The National Academy Of Sciences Of Ukraine ,Kyiv, Ukraine, Bogomolets National Medical University , Kyiv, Ukraine.
Jazyk:	angličtina
Zdroj:	Wiadomosci lekarskie (Warsaw, Poland : 1960) [Wiad Lek] 2019; Vol. 72 (11 cz 1), pp. 2108-2112.
Abstrakt:	Objective: Introduction: The recent recommendations have luck of information about regional anesthesia as one of the ERAS key component within the structure of multimodal analgesia in obese patients .The Ultrasound- guided Transversus abdominis plane blockade (USG- TAP-blockade) is a new regional anesthetic technique to reduce peri-operative pain for many abdominal surgeries. The aim of this study is to assess the efficiency of analgetic action of USG- TAP-blockade in morbid obese (MO) patients undergoing laparoscopic surgery (LS). Patients and Methods: Materials and methods: 90 MO patients were assigned to one of two equal groups; The first group (n1=45) included patients who underwent LS surgery in the lower abdomen and in the pelvis, second group (n2=45) included patients, who underwent LS surgery in the upper and middle part of the abdominal cavity. All patients had bilateral USG- TAPblockade with systemic analgesia .The primary efficacy end point- reduction of the intraoperative dose of opioids, the need for rescue analgesia in the first 6 postoperative hours. Results: Results: The fentanyl intravenous dose in n1=55 was considerably decreased : 1.34 ±0.15 μg / kg /h vs 2.2±0.18 μg / kg /h in second group , (р=0.032). The pain level by VAS in patients in both groups, in average, did not exceed 4 points within the first post-operative day, and there was no need in life-saving analgesia with narcotic analgetics. Conclusion: Conclusion: The USG- TAP-blockade has analgetic and opioid-sparing advantages in MO patients undergoing laparoscopic surgery in the lower abdomen and in the pelvis and may be a part of the efficient multimodal analgesia within ERAS in that patient's group.
Databáze:	MEDLINE
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