title: Ultrasound-guided Transversus Abdominis Plane Block Improves Postoperative Analgesia and Early Recovery in Patients Undergoing Retroperitoneoscopic Urologic Surgeries: A Randomized Controlled Double-blinded Trial.
abstract: <strong>Objective</strong> To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. <strong>Methods</strong> This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline. All patients received retroperitoneoscopic urologic surgeries under general anesthesia. The primary outcome was the severity of pain after surgery. Secondary outcomes included opioids consumption, analgesics, postoperative nausea and vomiting, time to Foley catheter removal and to passage of flatus, length of post-anesthesia care unit stay and hospital stay. <strong>Results</strong> Eighty patients completed the study, forty cases in each group. Compared to the Group C, the Group TAP had lower visual analogue scale pain scores within two postoperative days (all P<0.05). They also had less consumption of intraoperative fentanyl (2.0±0.5 vs. 3.8±0.7 μg/kg, P<0.05), reduced incidence of postoperative rescue analgesic usage (12.5% vs. 45.0%, P<0.05), and lower incidence of postoperative nausea and vomiting within postoperative 48 hours (12.5% vs. 25.0%, P<0.05) when compared to the Group C. In addition, Group TAP had a shortened post-anesthesia care unit stay (25±8 vs. 49±12 minutes, P<0.05), and a greater proportion of patients discharged within postoperative three days (57.5% vs. 35.0%, P<0.05). <strong>Conclusion</strong> Preoperative ultrasound-guided TAP block is an effective technique to improve postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries.
authors.affiliation: Department of Anesthesiology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Qu
authors.affiliation: Department of Anesthesiology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: Xu-Lei
authors.initials: XL
authors.lastname: Cui
authors.affiliation: Department of Anesthesiology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: Hong-Ju
authors.initials: HJ
authors.lastname: Liu
authors.affiliation: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Ji
authors.affiliation: Department of Anesthesiology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: Yu-Guang
authors.initials: YG
authors.lastname: Huang
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging* / Q000294:innervation; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000628:therapy*; D018084:Ultrasonography, Interventional