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Minerva Anestesiologica 2018 January;84(1):18-24

DOI: 10.23736/S0375-9393.17.11538-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Efficacy of US-guided transversus abdominis plane block and rectus sheath block with ropivacaine and dexmedetomidine in elderly high-risk patients

Lili XU 1, 2, 3, Zhiyong HU 4 , Jianjun SHEN 3, Patrick M. MCQUILLAN 5

1 Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China; 2 Department of Anesthesiology, Hangzhou First People’s Hospital, Hangzhou, China; 3 Department of Anesthesiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; 4 Department of Anesthesiology, Children’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China; 5 Department of Anesthesiology and Perioperative Medicine, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA


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BACKGROUND: This study was designed to evaluate the effectiveness and safety of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks with ropivacaine and dexmedetomidine in elderly, high-risk patients undergoing emergency abdominal surgery.
METHODS: Sixty elderly patients undergoing emergency abdominal surgery receiving both bilateral ultrasound-guided TAP and RS blocks were randomly divided into two groups: R+D (10 mL of 0.25% ropivacaine+0.5μg/kg dexmedetomidine) and R (10 mL of 0.25% ropivacaine). Pain scores (at rest and with movement) and overall analgesia satisfaction were assessed. The total amount of sufentanil administered postoperatively during the first 24 h, duration of sensory blockade, first time and total number of patient-controlled intravenous analgesia (PCIA) pump activations on the first postoperative day were recorded.
RESULTS: The duration of sensory blockade and the first time to PCIA pump activation in the R+D group were longer than that of the R group (P<0.05). The total number of PCIA pump activations on the first postoperative day as well as the total amount of sufentanil administered during the first 24 h in R+D group were less than in the R group (P<0.05). VAS scores at rest and during activity in the R+D group were lower than those in the R group at 2, 6, and 12 h after surgery (P<0.05).
CONCLUSIONS: Ultrasound-guided TAP and RS blocks with ropivacaine and dexmedetomidine are more effective in promoting block effect, prolonging the duration of analgesia, reducing postoperative pain in elderly high-risk patients undergoing emergency abdominal surgery.


KEY WORDS: Computer-assisted surgery - Abdominal muscles - Rectus abdominis - Emergency treatment - Dexmedetomidine

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