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ANALGESIC EFFECTS AND CUTANEOUS SENSORY BLOCK LEVELS OF QUADRATUS LUMBORUM BLOCK AND POSTERIOR TRANSVERSUS ABDOMINIS PLANE BLOCK: A PROSPECTIVE, DOUBLE-BLIND STUDY
ESRA Academy. Aoyama Y. Sep 9, 2016; 138448
Topic: REGIONAL ANAESTHESIA (RA) TECHNIQUES - CLINICAL IMPLICATIONS
Yuki Aoyama
Yuki Aoyama

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Abstract
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Background and Aims:

During the last several years, posterior transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have been developed as a regional anesthetic technique using ultrasound for postoperative pain control after abdominal surgery.  However, their analgesic effects or sensory blockade have not rigorously been explored.  Accordingly, this prospective study was conducted to observe their effects after laparoscopic gynecologic surgery.

Methods:

With IRB approval and informed consent, we studied 20 consecutive patients (ASA 1-2) undergoing laparoscopic gynecological surgery.  The patients were divided into two groups receiving QLB or TAPB.  Both blocks were conducted by injecting 20ml of 0.375% levobupivacaine each side after tracheal intubation.  General anesthesia was maintained by using propofol titrated to maintain BIS of 40-60, and remifentanyl 0.05-0.15 mcg/kg/min.  When heart rate and/or blood pressure increased > 20% from its baseline, fentanyl 1 mcg/kg was added intravenously.  Patients postoperatively received intravenous patient controlled analgesia with fentanyl.  Postoperative measurements included visual analog scale (VAS) pain scores at rest and while coughing, cutaneous sensory levels as determined by loss of cold and pinprick sensation, postoperative fentanyl consumption, use of additional analgesic requested, and adverse events for 48h.

Results:

Neither QLB nor TAPB produced cutaneous sensory block cosistently(table). Analgesic effects including VAS and fentanyl consumption were similar between the two techniques.

Conclusions:

For postoperative pain management of laparoscopic gynecologic surgery, QLB and TAPB can be used interchangeably.

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