Intertransverse process block versus subcostal transversus abdominis plane block in patients undergoing laparoscopic radical gastrectomy: a prospective randomized controlled trial.
作者信息
Chen Qian, Zhou Xinyue, Wang Fang, Zeng Yang, Qian Bin, Du Haiyun
机构信息
The Yancheng Clinical College of Xuzhou Medical University, No 166 Yulong Road, Yancheng, Jiangsu, 224000, China.
Department of Anesthesiology, The First People's Hospital of Yancheng, No 166 Yulong Road, Yancheng, Jiangsu, 224000, China.
出版信息
BMC Anesthesiol. 2025 Jan 7;25(1):9. doi: 10.1186/s12871-024-02884-0.
BACKGROUND
Laparoscopic radical gastrectomy has been reported to be associated with substantial trauma and pain. This study compared the impact of ultrasound-(US)-guided, bilateral, double-injection intertransverse process block (ITPB) on postoperative analgesia with subcostal transversus abdominis plane block (TAPB) in patients who were undergoing laparoscopic radical gastrectomy.
METHODS
Sixty-two patients who were undergoing laparoscopic radical gastrectomy surgery under general anesthesia were included. These patients were randomized to either the ITPB group or the TAPB group. Patients in the ITPB group received a double-shot US-guided bilateral ITPB at the thoracic level T6/7 and T9/10 level using ropivacaine (0.3%, 15 mL). Patients in the TAPB group received bilateral subcostal TAPB one injection per side using ropivacaine (0.3%, 30 mL). All patients used a BIS-guided combined intravenous and inhalation anesthesia. The primary outcome was defined as postoperative morphine-equivalent consumption during the first 24 h.
RESULTS
The study recruited 62 patients (31 in each group) for the analysis. A comparatively less postoperative opioid consumption was observed in the ITPB group compared with the subcostal TAPB group within the first 24 h postoperatively (mean [standard deviation-(SD)] morphine-equivalent dose): 27.8 (5.7) mg vs 31.2 (4.4) mg, P < 0.001. The ITPB group showed lower intraoperative opioid use, and statistical significantly lower scores at rest and coughing at 6, 24 h postoperatively. The time to first requiring rescue analgesia was longer in the ITPB group than the subcostal TAPB group (median [IQR]): 8.0 [8.0] vs 6.0 [6.0] h, P = 0.009. The patients in the ITPB group exhibited earlier independent movement, lower incidence of postoperative complications and higher levels of satisfaction (P = 0.021).
CONCLUSION
This study showed that the double-shot bilateral ITPB could reduce opioids consumption and achieve longer and better pain relief. Additionally, it promoted early postoperative activity and improved patient satisfaction.
TRIAL REGISTRATION
ChiCTR2300072986. Registered 29 June 2023.
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