Effect Of Transverse Abdominal Plane Block On Postoperative Rehabilitation In Patients Undergoing Colorectal Surgery

Objective : To provide reasonable postoperative analgesia program and accelerate the postoperative rehabilitation for patients undergoing colorectal surgery by studying the effect of transverse abdominal plane block.Methods: The study retrospectively analyzed the data of patients undergoing colorectal surgery in our hospital from September 2018 to March 2019.According to the inclusion and exclusion criteria and excluding the missing data,a total of 91 patients were enrolled.Patients were divided into control group(C group,n=40)and transverse abdominal muscle block group(T group,n=51)according to the transverse abdominal plane block was performed or not.The patients in both groups received the patient-controlled intravenou analgesia containing opioid analgesics.The postoperative hospital stay,the first postoperative defecation time,the first postoperative eating time,the time of removal of urinary catheter,the consumption of opioids 24 hours after operation,the first pressing analgesic pump time after operation,the VAS score during the three days and the incidence of nausea and vomiting after operation are compared between the two groups.Results: 1 There was no significant difference in age,height,weight,sex and operation time between the two groups(P > 0.05).2 Compared with group C,the hospital stay [12(10,14)VS 14(11,17)days,median(first quartile,third quartile)],the first defecation time after operation [5(4,7)VS 6(4,9)days,median(first quartile,third quartile)] in group T were significantly shorter(P < 0.05),but there are no significant difference in the the time of first eating and the time of urinary catheter removal after operation(P > 0.05).3 Compared with group C,24-hour opioid consumption(28.5±15.4 VS 39.4±23.3 mg,mean±standard deviation)in group T decreased(P < 0.05),and the time of first pressing analgesia pump [6.0(2.0,12.0)VS 2.0(1.0,7.8),median(first quartile,third quartile)] prolonged(P < 0.05).4 There is no significant difference in VAS score between the two groups at different time points within 3 days after operation(P >0.05),but the pain score at rest was mild.5 There was no significant difference in the incidence of postoperative nausea and vomiting between the two groups(P > 0.05).Conclusions: 1 The application of TAP block in multimodal analgesia after colorectal surgery can shorten the first defecation time and the hospital stay after operation..2 The application of TAP block in multimodal analgesia after colorectal surgery can reduce opiate consumption and prolong the first rescue analgesia time in 24 hours after operation.3 Both of the TAP block combined with the patient-controlled intravenou analgesia containing opioid analgesics and the single patient-controlled intravenou analgesia containing opioid analgesics can achieve good analgesic effect after colorectal surgery.