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| Application of Ultrasound-guided Transverse Abdominis Plane Block in Laparoscopic Cholecystectomy |
| ZHANG Xiaoming, XU Xinhua, TU Qunfang, LUO Heguo, WU Qingqing, CHEN Bochao, ZHU Yuelin |
| First-author's address: The First Hospital of Nanchang, Nanchang 330008, China |
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Abstract Objective: To investigate the application effect of ultrasound-guided transverse abdominis plane block in laparoscopic cholecystectomy. Method: A total of 60 patients undergoing laparoscopic cholecystectomy admitted to the First Hospital of Nanchang from January 2020 to December 2022 were selected and divided into control group and experimental group according to random number table method, with 30 cases in each group. Both groups were given anesthesia induction with 1.5-2 mg/kg Propofol, 0.1-0.2 μg/kg Sufentanil, 0.02 mg/kg Midazolam and 0.2 mg/kg Atracurium. The experimental group received ultrasound-guided transverse abdominis plane block and 10 mL of 0.25% Ropivacaine was injected, while the control group injected the same dose of normal saline. The mean arterial pressure (MAP), heart rate (HR) and percutaneous arterial oxygen saturation (SpO2) of the two groups were recorded before skin incision (T0), during skin incision (T1), 15 min after skin incision (T2), 30 min after skin incision (T3) and immediately after operation (T4). The total amount of Propofol and Remifentanil used, the first postoperative exhaust time and eating time in the two groups were recorded. Visual analogue scale (VAS) scores of the two groups were recorded at 0.5, 1, 2, 6, 12 and 24 h after awakening, and the occurrence of adverse reactions were recorded in both groups. Result: At T0 time point, there were no significant differences in MAP and HR levels between the two groups (P>0.05). At T1, T2 and T3 time point, the levels of MAP and HR in the two groups showed a downward trend, but those in the experimental group were higher than those in the control group (P<0.05). At T4 time point, the levels of MAP and HR in both groups were higher than those at T3, and those in the experimental group were higher than those in the control group (P<0.05). There were no significant differences in SpO2 levels between the two groups at T0, T1, T2, T3 and T4 time point (P>0.05). The dosage of Propofol and Remifentanil in the experimental group were less than those in the control group, and the first postoperative exhaust time and eating time in the experimental group were shorter than those in the control group (P<0.05). The VAS scores of the experimental group were lower than those of the control group at each time point after awakening (P<0.05). The incidence of adverse reactions in the experimental group (6.67%) was lower than that in the control group (26.67%) (P<0.05). Conclusion: The application of ultrasound-guided transverse abdominis plane block in laparoscopic cholecystectomy can reduce hemodynamic fluctuation, and has the advantages of less anesthetic dosage, rapid postoperative recovery, light pain and low incidence of adverse reactions.
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Received: 17 April 2023
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