Effect Of Preoperative And Postoperative Transversus Abdominis Plane Block On Postoperative Analgesia In Patients Undergoing Radical Resection Of Colorectal Cancer

Objective: To investigate effect of preoperative and postoperative transversus abdominis plane block on postoperative analgesia in patients undergoing radical resection of colorectal cancer.Methods: Sixty patients scheduled for radical resection of colorectal cancer under general anesthesia were allocated randomly to receive TAPB with 0.375% ropivacaine 20 ml each side,either pre-incisional(group A,n=30)or at the end of surgery(group B,n=30).Each group received patient-controlled intravenous analgesia.The visual analogue scale(VAS)score and the bruggrmann comfort scale(BCS)score at postoperative 1,2,4,8,12,24 and 48 h were recorded.The intraoperative dose of remifentanil,the number of compressions for analgesic pump and the adverse reactions within 48 h after operation were recorded.The levels of venous blood interleukin-6(IL-6)and C-reactive protein(CRP)before surgery(T0)and immediately after surgery(T1)were measured.Results: The scores of VAS at postoperative 1,2,4 and 8 h in group A were significantly lower than those in group B,the scores of BCS at postoperative 1,2,4 and 8 h in group A were significantly higher than those in group B,and there was significant difference(P<0.05).The dosage of remifentanil in group A was significantly less than that in group B:(0.53±0.23)mg vs.(0.73±0.34)mg,P<0.05.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Immediately after surgery,the IL-6 in group A were significantly lower than those in group B:(52.68±12.94)pg/ml vs.(60.28±11.90)pg/ml,P<0.05.There was no significant difference in the CRP between the two groups(P>0.05).Conclusion:Compared with TAPB after surgery,the pre-incisional TAPB can reduce the early pain after surgery,improve the comfort of patients,and reduce the level of IL-6.