Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Effectiveness of ultrasound-guided transversus abdominis plane block and rectus sheath block in pain control and recovery after gynecological transumbilical single-incision laparoscopic surgery
M. Mugita 1, R. Kawahara 2,*
, Y. Tamai 2, K. Yamasaki 2, S. Okuno 2, R. Hanada 2, M. Inaoka 3, T. Funato 4
, Y. Tamai 2, K. Yamasaki 2, S. Okuno 2, R. Hanada 2, M. Inaoka 3, T. Funato 4Affiliations
Article Info
1 Department of Rehabilitation
2 Department of Anesthesiology and Palliative Care
3 Department of Orthopedics
4 Department of Obstetrics and Gynecology, Nissay Hospital, Osaka (Japan)
Abstract
Purpose: To evaluate the effectiveness of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks in pain management and recovery after gynecological single-incision laparoscopic surgery (SILS). Materials and Methods: Abilateral TAP block (Group A, n=9), bilateral TAP and RS blocks (Group B, n=10), and a bilateral RS block (Group C, n=9) with 40 ml ropivacaine per patient were conducted in 28 patients undergoing SILS for ovarian tumors. A pain score and walking distance in a 6-minute walk test (6MWT) were examined. Results: Pain scores were significantly lower on postoperative day (POD) 3 than on POD 1 in Groups B (p = 0.03) and C (p = 0.02). The walking distance on POD 3 was comparable with that before surgery in Group C (p = 0.75), but shorter in Groups A (p = 0.004) and B (p = 0.02). Conclusions: The RS block alone was the most effective in relieving pain and accelerating general recovery after gynecological SILS.
Keywords
- Single-incision laparoscopic surgery
- Transversus abdominis plane block
- Rectus sheath block
- 6-minute walk test