The Analgesic Efficacy Of Ultrasound-guided Subcostal Ultipoint Transversus Abdominis Plane Block In Patients Undergoing The Abdominal Stomach Cancer Surgery

Objective:To observe the analgesic efficacy of bilateral subcostal ultrasound-guided transversusabdominis plane (TAP) block in patients undergoing gastric cancersurgery.Methods:Elective40cases of the patients with gastric cancer surgery byrandomized, double-blind, controlled trial,and divided into two groups, All of themwere received ultrasound-guided bilateral subcostal multi-point TAP after induction ofgeneral anestnesia, one group were injected with40ml of0.375%bupivacaine (group TM)and another group with the same dose of saline (group M). After30min the operationbegan,During the operation,the BIS was maintain between45~65. Postoperative jointvein self-control analgesia pump. Compared the systolic blood pressure (SBP),diastolicblood pressure (DBP) and heart rate(HR)before and after the incision of the two groups,recorded sufentanile and other vascular active drugs usage during surgery. Assessed theVisual Analogue Scale (VAS) of2,4,6,12,24and48h after operation. The range ofpostoperative patients with abdominal pain in2,4,6,12,24h after the surgery.Thepostoperative patients’ consumption of analgesia drug; Recorded the time interval to walkand venting; Recorded nausea, vomiting, drowsiness, and satisfaction with pain relief.Results:The changes of SBP,DBP,HR (△SBP、△DBP、△HR) before and after incision weresmaller in group TM(P <0.01). Postoperative analgesic effect is good in both groups,and2,4,6,12and48h postoperative VAS score of group TM were lower than group M(P <0.05).No adverse reactions occurred caused by TAP puncture in two groups.Comparedwith group M, the abdominal pain disappeared plane of TM group can maintain for6hours. The consumption of sufentanil greatly reduced with more satisfaction, patients canwalk earlier, venting earlier, and have better recovery.There is no complication cause byanesthesia. Conclusion:Ultrasound guided bilateral subcostal multi-point TAP block has the advantages ofaccurate positioning and high success rate,when it was used for gastric cancer surgery,notonly reduced the amount of anesthetic drugs,but also achieved a better analgesic effect.