Unilateral transversus abdominis plane block and port-site infiltration : Comparison of postoperative analgesic efficacy in laparoscopic cholecystectomy

Autor: Alp Alptekin, S. Ozciftci, T. Akkaya, Emine Arik, Ş. Balas
Přispěvatelé: [Belirlenecek]
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Nausea
Analgesic
Unilateral transversus abdominis plane block
Laparoscopic cholecystectomy
03 medical and health sciences
Young Adult
Opioid consumption
0302 clinical medicine
Patient satisfaction
Double-Blind Method
030202 anesthesiology
Transversus Abdominis Plane Block
Anesthesiology
medicine
Humans
Prospective Studies
Tramadol
Ultrasonography
Interventional
Abdominal Muscles
Aged
Bupivacaine
Aged
80 and over
Pain
Postoperative
Port-site infiltration
business.industry
Post-operative analgesia
030208 emergency & critical care medicine
Analgesia
Patient-Controlled
Nerve Block
General Medicine
Middle Aged
Analgesics
Opioid
Anesthesiology and Pain Medicine
Cholecystectomy
Laparoscopic
Cough
Anesthesia
Postoperative Nausea and Vomiting
Vomiting
Female
medicine.symptom
business
medicine.drug
Anesthesia
Local
Zdroj: Der Anaesthesist. 69(4)
ISSN: 1432-055X
Popis: Purpose To compare the analgesic efficacy of unilateral subcostal transversus abdominis plane (TAP) block with local anesthetic infiltration, applied to the port site in patients undergoing laparoscopic cholecystectomy (LC). Methods Group T received a unilateral subcostal TAP block, group I received a local anesthetic infiltration at port sites, and group C was the control group. Groups T and I received 20 mL 0.25% bupivacaine. Intravenous patient-controlled analgesia with tramadol was similarly applied to all groups. Postoperative pain levels during rest and cough were evaluated using a numeric rating scale (NRS). Nausea and vomiting were evaluated using postoperative nausea vomiting scores (PONV) at 1, 3, 6, 12 and 24h and tramadol consumption was also determined. Patient satisfaction was evaluated using a Likert-type scale. Results Postoperative resting NRS scores were lower in group T than the other groups at 1 h and 12 h (p = 0.007 and p = 0.016), while NRS values during cough were statistically significant at 1 h (p = 0.004). The 24-h tramadol consumption was different: group T 229 +/- 33 mg, group I 335 +/- 95 mg, and group C 358 +/- 66 mg (p< 0.001). The percentages of patients reporting that they would prefer the applied postoperative pain control method again were 83.3%, 62.5% and 70.8% in groups T, I and C, respectively (p = 0.118). Conclusion Unilateral subcostal TAP block was superior to local anesthetic infiltration at port sites after LC, in terms of low opioid consumption. Unilateral subcostal TAP block is recommended as part of a multimodal analgesic protocol. WOS:000524173800007 2-s2.0-85081714782 PubMed: 32166395
Databáze: OpenAIRE
Externí odkaz: