title: A novel transperitoneal abdominal wall nerve block for postoperative pain in laparoscopic colorectal surgery.
abstract: BACKGROUND
  Although the laparoscopic approach reduces pain associated with abdominal surgery, postoperative pain remains a problem. Ultrasound-guided rectus sheath block and transversus abdominis plane block have become increasingly popular means of providing analgesia for laparoscopic surgery.
  
  
  METHODS
  Ninety patients were enrolled in this study. A laparoscopic puncture needle was inserted via the port, and levobupivacaine was injected into the correct plane through the peritoneum. The patients' postoperative pain intensity was assessed using a numeric rating scale. The effects of laparoscopic nerve block versus percutaneous anesthesia were compared.
  
  
  RESULTS
  This novel form of transperitoneal anesthesia did not jeopardize completion of the operative procedures. The percutaneous approach required more time for performance of the procedure than the transperitoneal technique.
  
  
  CONCLUSIONS
  This new analgesia technique can become an optional postoperative treatment regimen for various laparoscopic abdominal surgeries. What we mainly want to suggest is that the transperitoneal approach has the advantage of a higher completion rate. A percutaneous technique is sometimes difficult with patients who have severe obesity and/or coagulation disorders. Additional studies are required to evaluate its benefits.
authors.affiliation: Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan. Electronic address: junsgy@gmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Nagata
authors.affiliation: Department of Surgery, Yokosuka Kyosai Hospital, Kanagawa, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sawatsubashi
authors.affiliation: Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Akiyama
authors.affiliation: Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Arase
authors.affiliation: Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Minagawa
authors.affiliation: Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Torigoe
authors.affiliation: Department of Anesthesiology, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Hamada
authors.affiliation: Department of Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Nakayama
authors.affiliation: Department of Surgery, University of Occupational and Environmental Health, Fukuoka, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hirata
mesh_terms: D034861:Abdominal Wall; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D010535:Laparoscopy; D000077554:Levobupivacaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000628:therapy*; D010537:Peritoneum
chemical_list: D000077554:Levobupivacaine
keywords: colorectal surgery; nerve block; postoperative pain; rectus sheath block; transversus abdominis plane block