Zhang Liwen, Liu Aihong, Wang Lei, Zhang Yanping, Hu Zhaolan
Discipline of Anesthesiology, Qingdao Medical College, Qingdao University, Qingdao, China.
Department of Gynecology, Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, China.
Front Med (Lausanne). 2025 Mar 5;12:1541462. doi: 10.3389/fmed.2025.1541462. eCollection 2025.
The ultrasound-guided transversus abdominis plane (TAP) block has emerged as an effective adjunctive analgesic technique for abdominal surgery. However, its use in older patients with significant ascites has been rarely documented. This report presents the anesthetic management of an older patient with massive ascites undergoing open laparotomy for an ovarian tumor. Preoperatively, 30 mL of 0.2% levobupivacaine was injected into the TAP under ultrasound guidance. The procedure was uneventful, with approximately 9,000 mL of ascitic fluid drained, along with the removal of a 13 × 13 × 7-cm left ovarian mass, an 8 × 5.5 × 4-cm uterus, and a 3.5 × 1 × 0.5-cm right ovary. Throughout the surgery, the patient maintained hemodynamic stability, with no significant fluctuations in blood pressure or heart rate. Postoperatively, the patient reported minimal pain and experienced no adverse effects. These findings highlight the effectiveness of ultrasound-guided TAP block as an auxiliary anesthesia technique, providing enhanced analgesia, promoting hemodynamic stability, and improving overall anesthetic outcomes in older patients with substantial ascites.
超声引导下的腹横肌平面（TAP）阻滞已成为腹部手术一种有效的辅助镇痛技术。然而，其在有大量腹水的老年患者中的应用鲜有文献记载。本报告介绍了一名患有大量腹水的老年患者接受卵巢肿瘤开腹手术的麻醉管理情况。术前，在超声引导下向腹横肌平面注射了30毫升0.2%的左旋布比卡因。手术过程顺利，引出了约9000毫升腹水，同时切除了一个13×13×7厘米的左侧卵巢肿物、一个8×5.5×4厘米的子宫和一个3.5×1×0.5厘米的右侧卵巢。在整个手术过程中，患者保持血流动力学稳定，血压和心率无明显波动。术后，患者报告疼痛轻微，未出现不良反应。这些发现突出了超声引导下TAP阻滞作为一种辅助麻醉技术的有效性，可为有大量腹水的老年患者提供增强的镇痛效果，促进血流动力学稳定，并改善整体麻醉效果。
