The Spread Of Injectate In Transversus Abdominis Plane Block And Its Effects On Abdominal Wall Pain

Objective To explore the spread of injectate of ultrasound-guided lateral approach transversus abdominis plane block(TAP block)and its effects on abdominal wall pain(AWP).Methods A total of 40 patients with abdominal wall pain diagnosed and treated by our hospital from March 2016 to October 2017 were randomly divided into Group A and Group B(20 cases in each group).After confirming the needle tip is on the transversus abdominis plane,patients in Group A was injected with the local anesthetic solution with contrast agent of 10 ml.Patients in Group B was injected with the local anesthetic solution with contrast agent of 20 ml.Observe and assess the spread areas of contrast agent under the DSA.Compare and analyze the visual analog scores(VAS)at 7 days,1 months and 3 months after treatment.According to the VAS,the efficacy was rated as excellent(the relieving percentage>75%),marked effective(50%-75%),effective(25%-50%)and invalid(<25%).Calculate the effective rate[(excellent+marked effective+effective cases)/total cases]x100%.Results1.The ages,body weights and VAS before the treatment(7.21±2.26 vs 6.92±2.33)of two groups of patients are not statistically significant.2.No infection,hematoma,nerve injury,medication allergy and intolerance occurred during the treatment of all patients.3.The spread area of Group B was distinctly larger than that of Group A(P<0.05).Comparatively,the VAS of the two groups of patients declined(P<0.05)after the 7-day,1-month and 3-month treatment(Group A2.75±0.79,3.45±0.65,3.50±0.77;Group B 1.88±0.48,2.05±0.47,2.22±0.50).And in Group B,the declining range of VAS was larger.4.The effective rates are following statistics:in Group A were 65%,50%,40%after the 7-day,1-month and 3-month treatment respectively;in Group B were 85%,75%,75%.In different periods,the effective rates of Group B were distinctly higher than the Group A.Conclusion1.Different volumes of injectate spread similarly as leaf-shaped.2.Extending the spread area by injecting larger volume solution,may lead to a better and long-term effect of AWP treatment.