The additional analgesic effects of transverse abdominis plane block in patients receiving low-dose intrathecal morphine for minimally invasive colorectal surgery: a randomized, single-blinded study

Seung-Rim Han; Chul Seung Lee; Jung Hoon Bae; Hyo Jin Lee; Mi Ran Yoon; Do Sang Lee; Yoon Suk Lee; Abdullah Al-Sawat; Jung-Woo Shim; Sang-Hyun Hong; In Kyu Lee

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저자정보: Seung-Rim Han (The Catholic University of Korea) Chul Seung Lee (The Catholic University of Korea) Jung Hoon Bae (The Catholic University of Korea) Hyo Jin Lee (The Catholic University of Korea) Mi Ran Yoon (The Catholic University of Korea) Do Sang Lee (The Catholic University of Korea) Yoon Suk Lee (The Catholic University of Korea) Abdullah Al-Sawat (The Catholic University of Korea) Jung-Woo Shim (The Catholic University of Korea) Sang-Hyun Hong (The Catholic University of Korea) In Kyu Lee (The Catholic University of Korea)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.101 No.4

발행연도: 2021.10

수록면: 221 - 230 (10page)

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Purpose: Intrathecal analgesia (ITA) and transverse abdominis plane block (TAPB) are effective pain control methods in abdominal surgery. However, there is still no gold standard for postoperative pain control in minimally invasive colorectal surgery. This study aimed to investigate whether the analgesic effect could be increased when TAPB, which can further reduce wound somatic pain, was administered in low-dose morphine ITA patients.
Methods: Patients undergoing elective colorectal surgery were randomized into an ITA with TAPB group or an ITA group. Patients were evaluated for pain 0, 8, 16, 24, and 48 hours after surgery. The primary outcome was the total morphine milligram equivalents administered 24 hours after surgery. The secondary outcomes were pain scores, ambulatory variables, inflammation markers, hospital stay duration, and complications within 48 hours after surgery.
Results: A total of 64 patients were recruited, and 55 were compared. There was no significant difference in morphine use over the 24 hours after surgery in the 2 groups (ITA with TAPB, 15.3 mg vs. ITA, 10.2 mg; P = 0.270). Also, there was no significant difference in pain scores. In both groups, the average pain score at 24 and 48 hours was 2 points or less, showing effective pain control.
Conclusion: ITA for pain control in patients with colorectal surgery is an effective pain method, and additional TAPB was not effective.

#Colorectal surgery #Enhanced recovery after surgery #Intrathecal analgesia #Transverse abdominis plane block

참고문헌 (29)

참고문헌 신청

Gustafsson UO / 2019 / Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018 / World J Surg 43:659~695

Levy BF / 2011 / Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery / Br J Surg 98:1068~1078

Kim WJ / 2021 / Surgical rectus sheath block combined with multimodal pain management reduces postoperative pain and analgesic requirement after single incision laparoscopic appendectomy: a retrospective study / Int J Colorectal Dis 36:75~82

Colibaseanu DT / 2019 / Randomized clinical trial of liposomal bupivacaine transverse abdominis plane block versus intrathecal analgesia in colorectal surgery / Br J Surg 106:692~699

Dewinter G / 2018 / Quadratus lumborum block versus perioperative intravenous lidocaine for postoperative pain control in patients undergoing laparoscopic colorectal surgery: a prospective, randomized, double-blind controlled clinical trial / Ann Surg 268:769~775

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