Comparison of Postoperative Analgesic Efficacy between Continuous Transversus Abdominis Plane Block, Lumbar Paravertebral and Epidural Blocks after Abdominal Surgeries  

作　　者：Mohamed Elmeliegy 

机构地区：[1]Anaesthesia Department, Benha University, Benha, Egypt

出　　处：《Open Journal of Anesthesiology》2018年第11期267-279,共13页麻醉学期刊（英文）

摘　　要：Background: The study was done to assess the postoperative analgesic efficacy of ultrasound-guided continuous transverses abdominis plane block, continuous lumbar paravertebral block and a continuous lumbar epidural block in patients undergoing lower abdominal surgeries (unilateral inguinal hernia repair). We compared their analgesic efficacy over the first 48 hour postoperative, in a randomized, single-blind study in 120 patients divided into four equal groups, 30 patients in each group. Methods: 120 patients randomly assigned into four equal groups, with 30 patients in each group. Group T received ultrasound-guided transverses abdominis plane block with 20 ml of bupivacaine 0.25% followed by continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr) and group P received ultrasound-guided continuous lumbar paravertebral block with bupivacaine 0.25% bolus dose 20 ml, followed by continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr). Group E received continuous lumbar epidural infusion of bupivacaine 0.25% bolus dose 20 ml, followed by continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr) and group C received normal saline bolus dose 20 ml, followed by continuous infusion of normal saline (0.1 ml/kg/hr). General anesthesia induced with fentanyl 1 - 2 μg/kg and propofol 1 - 3 mg/kg followed by atracurium 0.5 mg/kg. At the end of the surgical procedure, we activated the regional block with recording of parameters in the postoperative period each patient was assessed for visual analog scale (VAS) at rest and on movement, analgesic consumption, vital signs and presence of complications (nausea, vomiting, sedation), and postoperative patient satisfaction all data collected postoperatively by a blinded investigator at one, two, 6, 12, 24 and 48 hours postoperatively. Results: Postoperative analgesic efficacy is more in group E than group P and group T, the latter is least effective in pain control. Also in group E the postoperative analgesic consumption is lower than in group P and group T, re-garding complicationsBackground: The study was done to assess the postoperative analgesic efficacy of ultrasound-guided continuous transverses abdominis plane block, continuous lumbar paravertebral block and a continuous lumbar epidural block in patients undergoing lower abdominal surgeries (unilateral inguinal hernia repair). We compared their analgesic efficacy over the first 48 hour postoperative, in a randomized, single-blind study in 120 patients divided into four equal groups, 30 patients in each group. Methods: 120 patients randomly assigned into four equal groups, with 30 patients in each group. Group T received ultrasound-guided transverses abdominis plane block with 20 ml of bupivacaine 0.25% followed by continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr) and group P received ultrasound-guided continuous lumbar paravertebral block with bupivacaine 0.25% bolus dose 20 ml, followed by continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr). Group E received continuous lumbar epidural infusion of bupivacaine 0.25% bolus dose 20 ml, followed by continuous infusion of bupivacaine 0.125% (0.1 ml/kg/hr) and group C received normal saline bolus dose 20 ml, followed by continuous infusion of normal saline (0.1 ml/kg/hr). General anesthesia induced with fentanyl 1 - 2 μg/kg and propofol 1 - 3 mg/kg followed by atracurium 0.5 mg/kg. At the end of the surgical procedure, we activated the regional block with recording of parameters in the postoperative period each patient was assessed for visual analog scale (VAS) at rest and on movement, analgesic consumption, vital signs and presence of complications (nausea, vomiting, sedation), and postoperative patient satisfaction all data collected postoperatively by a blinded investigator at one, two, 6, 12, 24 and 48 hours postoperatively. Results: Postoperative analgesic efficacy is more in group E than group P and group T, the latter is least effective in pain control. Also in group E the postoperative analgesic consumption is lower than in group P and group T, re-garding complications

关 键 词：EPIDURAL PARAVERTEBRAL TAP Block POSTOPERATIVE ANALGESIA Ultrasound Guided 

分 类 号：R73[医药卫生—肿瘤]