Basic & Clinical Medicine ›› 2019, Vol. 39 ›› Issue (6): 826-831.

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Ultrasound-guided transversus abdominis plane blocks versus local anesthetic wound infiltration in laparoscopic radical cystectomy and ERAS program

  

  • Received:2019-04-01 Revised:2019-04-17 Online:2019-06-05 Published:2019-06-04

Abstract: Objective To evaluate ultrasound guided transversus abdominis plane(U-TAP) block compared to local anesthetic(LA)wound infiltration in laparoscopic radical cystectomy and (enhanced recovery after surgery,ERAS) program.. Methods Seventy-five patients who underwent elective laparoscopic radical cystectomy were randomly divided into: control group (group C,n=35): LA combined intravenous analgesia ;study group (group S,n=35): US-TAP combined intravenous analgesia, patients received 20 ml of 0.35% ropivacaine(total 40 mL)as US-TAP inhibitors each side after the end of surgery by the anesthesiologist.All patients underwent the ERAS perioperative program and received patient-controlled intravenous analgesia (PCIA) . Visual analogue pain (VAS) score at different time points and postoperative rapid recovery index were observed and recorded in the two groups.Meanwhile, the cumulative sufentanil consumption at 24 hours, the first PCA compression time ,the number of effective compressions and patient satisfaction score,; The incidence of side effects (nausea and vomiting and pruritis) were recorded in both groups.Results Compared with group C,group S had significantly lower VAS pain score at 24h and 48h after surgery (P< 0.05), and significantly shorter time of first intestinal exhaust, first time out of bed and length of stay .(P<0.01).The first postoperative PCIA compression time, the PCIA effective compression times and the total consumption of sufentanil in 24 hours in S group were significantly less than those in C group, the incidence of nausea and vomiting in 24 hours were significantly lower in group S than that in the C group (P <0.05). There was no statistical difference between the two groups in incision infection and skin itching. Conclusions Compared with LA combined with intravenous analgesia,US-TAP block combined with intravenous analgesia is beneficial to early recovery and shortens hospital stay in laparoscopic radical cystectomy and ERAS program.

Key words: ERAS, Regional anesthesia, TAP block, radical cystectomy

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