TRANSVERSUS ABDOMINIS PLANE BLOCK AFTER LAPAROSCOPIC SURGERY AND LAPAROTOMY COMPARED WITH OPIOID ANALGESIA
Actuality. Adequate postoperative analgesia is essential for successful recovery after laparoscopic surgery and laparotomy. Opioids are commonly used to treat severe postoperative pain, and their use is often associated with many dose-dependent side effects such as nausea, vomiting, constipation, ileus, and respiratory depression]. Thus, a reduction in the administration of opioids is highly desirable, and multimodal forms of postoperative anesthesia are preferred. For this reason, the blockade of the transverse plane of the abdomen has received much attention.
Aim of this study was to evaluate the effectiveness of TAP blockade after laparoscopic surgery and laparotomy and compare it with standard systemic anesthesia.
Materials and methods of research: We analyzed the results of pain relief in 120 patients who underwent laparoscopic surgery or laparotomy and were divided into two equal (n=60) groups. One group received bipolar TAP block in the early postoperative period (within the first 24 hours). In addition, patients in this group also received intravenous administration of ketonal. The second group received the standard systemic administration of the narcotic analgesic Promedol and Ketonal during the first day after the operation.
Statistical significance was determined using unpaired two-tailed Student's t-test. Statistical processing of the material was carried out using the software package Statistica v. 7.0.
Results: The assessment of pain in the first 24 hours after surgery using the visual analog scale (VAS) did not reveal significant differences between the groups, except for the assessment after 5 hours, where the difference between the groups was significant (p < 0.05). Patient satisfaction with anesthesia, assessed on the Likert scale, did not reveal significant differences between the groups. Similarly, assessments of surgeons' satisfaction with anesthesia did not reveal a significant difference between the groups. We did not find any statistical differences in heart rate, systolic and diastolic blood pressure between the two experimental groups. We also assessed the volume of systemic analgesics used in the first 24 hours after surgery. Ketonal was used in both groups at 400 mg (p>0.5). Promedol was used only in the group of narcotic analgesics 44.50 ± 7.4 mg (p<0.001).
Conclusion: Based on these results, we suggest that multimodal analgesia in the form of bipolar TAP blockade in combination with intravenous administration of ketonal provides adequate anesthesia in the postoperative period, comparable to standard systemic administration of opioids and ketonal.
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Ashzhanov R., Mamyrov D., Syzdykbayev M., Noso Yo., Tashtemirova O., Ashzhanova A., Sheinin A. Transversus abdominis plane block after laparoscopic surgery and laparotomy compared with opioid analgesia // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 1, pp. 100-105. doi 10.34689/SH.2023.25.1.013 Ашжанов Р., Мамыров Д., Сыздыкбаев М., Носо Йо., Таштемирова О., Ашжанова А., Шейнин А. Блокада поперечной плоскости живота после лапароскопической операции и лапаротомии в сравнении с опиоидной анальгезией // Наука и Здравоохранение. 2023. 1(Т.25). С. 100-105. doi 10.34689/SH.2023.25.1.013Related publications:
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