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Original Research
Effectiveness of ultrasound-guided transversus abdominis plane block and rectus sheath block in pain control and recovery after gynecological transumbilical single-incision laparoscopic surgery
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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)
Clin. Exp. Obstet. Gynecol. 2014, 41(6), 627–632;
https://doi.org/10.12891/ceog18712014
Published: 10 December 2014
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