Şengel Abdulhakim, Büyükfırat Evren, Seçilmiş Selçuk, Altay Nuray, Atlas Ahmet, Karahan Mahmut Alp
Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University, Osmanbey Campus, 63200 Sanlıurfa, Turkey.
Department of Anesthesiology and Reanimation, Kahta State Hospital, 02600 Adıyaman, Turkey.
Diagnostics (Basel). 2025 Aug 22;15(17):2122. doi: 10.3390/diagnostics15172122.
Laparoscopic appendectomy (LsA) is a standard acute surgical procedure typically performed under general anesthesia (GA). However, GA is associated with side effects such as hemodynamic instability and postoperative nausea/vomiting. Regional anesthesia (RA) has gained attention as an effective alternative in such surgeries, as it reduces surgical stress responses, provides adequate postoperative analgesia, and promotes early mobilization. This study evaluates the effectiveness of the combined use of spinal anesthesia (SA) and transversus abdominis plane block (TAPB) in LsA procedures. This retrospective observational study included 220 patients who underwent LsA between 2020 and 2023. Patients were divided into two groups: Group 1 ( = 110) received bilateral TAPB, and Group 2 ( = 110) received unilateral TAPB, both under SA. Postoperative pain was assessed using the Visual Analog Scale (VAS), and outcomes such as time to first analgesic requirement, analgesic consumption, and patient satisfaction were recorded. This study evaluated the effects of SA combined with TAPB in LsA. Bilateral TAPB significantly prolonged the time to first analgesic request (13.7 vs. 12.1 h; = 0.001) and reduced analgesic requirements ( = 0.008) compared to unilateral TAPB. VAS scores were significantly lower in Group 1 at the 9th and 12th hours postoperatively ( = 0.003 and = 0.039). Although overall satisfaction scores were similar, a higher proportion of patients in Group 1 reported being "very satisfied" or "excellent" (55.5% vs. 42.7%). The combination of spinal anesthesia and bilateral TAPB is a safe and effective anesthetic strategy for LsA. Compared to unilateral TAPB, it offers superior postoperative analgesia and improved patient satisfaction.
腹腔镜阑尾切除术（LsA）是一种标准的急性外科手术，通常在全身麻醉（GA）下进行。然而，全身麻醉会伴有血流动力学不稳定和术后恶心/呕吐等副作用。区域麻醉（RA）作为此类手术的一种有效替代方法受到关注，因为它能减轻手术应激反应，提供充分的术后镇痛，并促进早期活动。本研究评估了蛛网膜下腔麻醉（SA）联合腹横肌平面阻滞（TAPB）在LsA手术中的有效性。这项回顾性观察性研究纳入了2020年至2023年间接受LsA手术的220例患者。患者被分为两组：第1组（n = 110）接受双侧TAPB，第2组（n = 110）接受单侧TAPB，两组均在蛛网膜下腔麻醉下进行。使用视觉模拟评分法（VAS）评估术后疼痛，并记录首次需要镇痛的时间、镇痛药物用量和患者满意度等结果。本研究评估了蛛网膜下腔麻醉联合TAPB在LsA中的效果。与单侧TAPB相比，双侧TAPB显著延长了首次需要镇痛的时间（13.7小时对12.1小时；P = 0.001），并减少了镇痛药物用量（P = 0.008）。术后第9小时和第12小时，第1组的VAS评分显著更低（P = 0.003和P = 0.039）。尽管总体满意度评分相似，但第1组中报告“非常满意”或“优秀”的患者比例更高（55.5%对42.7%）。蛛网膜下腔麻醉联合双侧TAPB是LsA手术中一种安全有效的麻醉策略。与单侧TAPB相比，它提供了更好的术后镇痛效果，提高了患者满意度。
