The Effect Of Ultrasound-guided Transversus Abdominis Plane Block For Hepatectomy Post-operative Analgesia

Objective : To evaluate the effect of ultrasound-guided transversus abdominis plane(TAPB)for Hepatectomy post-operative analgesia.Methods:From August 2019 to January 2020,a total of 60 patients undergoing elective laparoscopic hepatectomy were randomly divided into S group(the block group)and D group(the control group),with 30 patients in each group 5 μg of Sufentanil and 5 mg of Flurbiprofen axetil were administered as a base analgesia 15 minutes before the end of the operation.Ondansetron 4mg were use to prevent nausea and vomiting after the operation.Patients in the S group received bilateral ultrasound-guided TAPB after the operation,while patients in the D group not received blocked after the operation.All patients received postoperative analgesia with sufentanil patient-controlled analgesia.After extubation,the patient’s visual analogue score was more than 4 points.The patient was first treated by pressing the analgesia pump,and if the pressure analgesia was ineffective,the patient was given 5 g sufentanil intravenously for analgesia.VAS score at each time point and sufentanil dosage 24 h after surgery were observed in the two groups.Number of times of analgesic pumpcompressions,the overall cumulative rescue analgesia percentage,postoperative recovery and related adverse reactions were observed in the two groups at each time point after surgery.Results:VAS scores in group S was lower than that in D group at extubation,after extubatio2 h,6h and 12h(P<0.05).Pain scores were not different at 24 h and 48 h after the operation(P>0.05).The accumulative consumption of sufentanil and the number of analgesic pump compressions in group S were lower than that in group D 24 hours after the operation(P<0.05).The Incidence of patients with postoperative nausea in group S were less than that in group D(P<0.05),and the overall cumulative rescue analgesia percentage in the two groups was not statistically significant(P>0.05).Respiratory depression,urinary retention,puncture site infection,local anesthetic poisoning did not occur.The first time to land and the first time to exhaust in group S were both less than that in group D(P<0.05).There was no significance in length of stay between the two groups(P>0.05)Conclusion: Ultrasound-guided TAPB has a good postoperative analgesic effect after hepatectomy,which reduce the use of sufentanil,reduce the adverse reactions,and promote the postoperative recovery of patients.