title: Analgesic efficacy of ultrasound-guided subcostal transversus abdominis plane block.
abstract: BACKGROUND
  To evaluate the analgesic efficacy on defined areas of the abdomen and back after ultrasound-guided subcostal transversus abdominis plane (TAP) block using 0.25% levobupivacaine 0.5 mL/kg.
  
  
  METHODS
  Twenty patients undergoing elective laparoscopic cholecystectomy, between 20 and 60 years of age with operative time <1 hour, received subcostal TAP block using 0.25% levobupivacaine 0.5 mL/kg on the left side. Surgery started after 1 hour of observation. Sensory assessment was undertaken using pinprick and 75% ethyl alcohol at 10, 20, 30 minutes, 1, 3, and 12 hours after TAP block at 19 testing zones that were divided by anatomic landmark lines on the abdomen and the back. Efficacy of zone was defined as loss of cold temperature sensation or loss of pinprick pain sensation in more than 50% patients in that testing zone. Duration was determined by analgesia and loss of temperature sensation beginning within 30 minutes of TAP block placement lasting until time points of 1, 3, and 12 hours. All of the testing zones were divided as Group I effective at 20 minutes in less than 50% patients (0%-50%), Group II 50% to 70% patients, Group III 70% to 90% patients, and Group IV 90% to 100% patients.
  
  
  RESULTS
  Twenty patients meeting the study requirements were included. At each time point, the efficacies among 4 groups were significantly different. Subcostal TAP had good efficacy and stable duration in zones 1, 2, 3, 5, and 6.
  
  
  CONCLUSIONS
  Subcostal TAP block with 0.25% levobupivacaine 0.5 mL/kg dose provided effective analgesia in the anterior abdominal wall between medioventral line to anterior axillary line except the lateral upper abdominal region.
authors.affiliation: Department of Anesthesiology Medical Records Room, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Ma
authors.forename: Yifei
authors.initials: Y
authors.lastname: Jiang
authors.forename: Shiyi
authors.initials: S
authors.lastname: Tang
authors.forename: Benfu
authors.initials: B
authors.lastname: Wang
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Lian
authors.forename: Zuokai
authors.initials: Z
authors.lastname: Xie
authors.forename: Jun
authors.initials: J
authors.lastname: Li
mesh_terms: D000009:Abdominal Muscles; D000328:Adult; D000698:Analgesia / Q000706:statistics & numerical data*; D000765:Anesthesia, Conduction / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D000077554:Levobupivacaine; D008875:Middle Aged; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine