title: Application of ultrasound-guided subcostal transversus abdominis plane block in gastric cancer patients undergoing open gastrectomy.
abstract: BACKGROUND
  To observe intraoperative and postoperative analgesic effect of ultrasound-guided subcostal transversus abdominis plane (TAP) block in gastric cancer patients undergoing open gastrectomy.
  
  
  METHODS
  Forty patients with gastric cancer underwent open gastrectomy were randomly assigned into groups R and S. All patients received ultrasound-guided subcostal bilateral TAP under general anesthesia, and then were injected with 40 ml of 0.375% ropivacaine (group R) or equivalent amount of normal saline (group S). The surgery was performed in 30 min following the blocking. Intraoperatively, BIS value was maintained between 45 and 65. Patient-controlled intravenous analgesia pump was properly connected after the operation. Intraoperative changes in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were observed and the dosage of sufentanil and alternative drugs was closely monitored during the surgery. Visual analogue scale (VAS) scores and related surgical complications were recorded at 2, 4, 6, 12, 24 and 48 h following the operation.
  
  
  RESULTS
  The SBP, DBP and HR changes in the group R were significantly decreased compared with those in the group S (all P<0.01). In both groups, desirable analgesic effect was obtained. The VAS scores at postoperative 2, 4, 6 and 12 h after the surgery in the group R were significantly lower than those in the group S (all P<0.05). No TAP puncture-induced adverse reaction was observed in both groups.
  
  
  CONCLUSIONS
  Ultrasound-guided subcostal transversus abdominis plane block has the advantages of accurate localization and high success rate. Clinical application of this technique in open gastrectomy can significantly decrease intraoperative and postoperative dosage of analgesics and exert desirable analgesic effect.
authors.affiliation: Department of Anesthesia, China-Japan Union Hospital of Jilin University Changchun 130021, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Anesthesia, China-Japan Union Hospital of Jilin University Changchun 130021, China.
authors.forename: Longyun
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Anesthesia, China-Japan Union Hospital of Jilin University Changchun 130021, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Gao
authors.affiliation: Department of Anesthesia, China-Japan Union Hospital of Jilin University Changchun 130021, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Anesthesia, China-Japan Union Hospital of Jilin University Changchun 130021, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Anesthesia, China-Japan Union Hospital of Jilin University Changchun 130021, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Anesthesia, China-Japan Union Hospital of Jilin University Changchun 130021, China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Zhao
keywords: Transversus abdominis plane; gastric cancer; nerve block; subcostal