Observation On The Feasibility Of Internal Oblique Plane Block Analgesia After Laparoscopic Cholecystectomy

Objective:By ultrasound-guided right internal oblique plane(IOP)block,to explore whether the IOP block has analgesic effect in various regions of the right abdomen,and then compare the IOP block with the transverse abdominis plane(TAP)block,to further verify the analgesic effect of IOP block after laparoscopic cholecystectomy.Methods part? :10 patients underwent laparoscopic cholecystectomy,who was given ultrasound-guided right IOP block with 20ml of 0.25%ropivacaine before anesthesia.The right abdomen is divided into seven regions by three vertical axes(Linea mediana ventralis,midclavicular line and anterior axillary line),three horizontal axes(horizontal line of xiphoid process,horizontal line between xiphoid process and umbilicus,horizontal line of umbilicus)and the inguinal line.The changes in pain in the above areas were measured by acupuncture at 10min,20min,and 30min after block.Part ?:60 patients undergoing elective laparoscopic cholecystectomy were randomly divided into the IOP group and the TAP group,with 30 cases in each group.According to different group,all patients were subjected to bilateral IOP block or TAP block after general anesthesia and before surgery,and each side was given 20%ropivacaine 20ml.The intraoperation consumption of sufentanil,remifentanil,and the requirement for postoperative rescue analgesic dezocine were recorded and compared,and postoperative resting pain and exercise pain at 30min,2h,6h,12h,24h,postoperative adverse reactions and 24-hour analgesia satisfaction were observed and compared.Results part ?:10 minutes after the block,the regions 2,3 and 5 of the right abdomen had block effect,but no region showed perfect block effect.20 minutes after the block,the regions 1,2,3 and 5 of the right abdomen had block effect,and the region 2 had perfect block effect.30 minutes after the block,thel regions 1,2,3,5 and 6 had block effect,and the regions 2,3 and 5 had perfect block effect.Part ?:Compared with the TAP group,there was no significant difference in the consumption of intraoperative sufentanil,remifentanil,and postoperative dezocine in the IOP group;There was no significant difference in the pain intensity between the IOP group and the TAP group at each observation time point,no matter in the resting state or the cough state;there was no significant difference in the incidence of postoperative vomiting,dizziness and dyspnea between the two groups,and there was no abnormal sedation and lower limb motor dysfunction in the two groups;There was no significant difference in 24-hour analgesia satisfaction between the two groups.Conclusion:Part ?:After ultrasound-guided right internal oblique plane block 10 minutes,the effect of pain reduction can obtain in the ipsilateral abdomen,and it can produce good pain reduction and disappearance effect at 30 minutes.Part ?:In the observation of patients undergoing laparoscopic cholecystectomy,the postoperative analgesic effects,side effects and satisfaction were similar between the preoperative IOP block and TAP block at the same time point.It is speculated that IOP block is also an alternative method in the choice of postoperative analgesia after abdominal surgery.