| Objective:To investigate the effect of continuous ultrsound-guided transversus abdominis plane block on efficacy of postoperative analgesia in patients undergoing laparoscopic colorectal surgery.Methods:Sixty adult patients undergoing elective laparoscopic colorectal surgery were randomly assigned to receive continuous transversus abdominis plane analgesia (TAP group) vs epidural analgesia (PCEA group), The TAP group received ultrsound-guided transversus abdominis plane blocks on each side postoperatively (a total of 2.5 mg/kg ropivacaine 0.375%) and bilateral lateral transversus abdominis plane catheters that were infused with ropivacaine 0.2% at a rate of 6 to 8 ml/h for 48 h. The PCEA group received an infusion of ropivacaine 0.15% and fentanyl 3μg/ml for 48 h.The pain score of visual analogue scale(VAS) on couging and at rest were evaluated at 2,6,12,24,36,and 48h after operation. The changes of TAP block level were recorded after operation.Surgical outcome measures included time to walk, time to pass flatus, time for removal of the urinary catheter and patient satisfaction at 48 h. Any complications were also recorded.Results:Fifty-five patients completed the study finally (TAP group:27,PCEA group:28). We found no significant difference in median visual analogue scores at rest (P=0.14) and on coughing (P=0.19) between the TAP group and the PCEA group over time. The range of TAP block was relatively fixed within 48 hours after surgery.There were no significant differences between the groups for tramadol consumption. There was,however, a significant difference between the groups for the time of removal of the urinary catheter (P <0.05).The incidence of naucea,vomiting and sensory disturbance in TAP group were lower than in PCEA group in the first 48 h postoperatively (P< 0.05)Conclusions:Continuous transversus abdominis plane infusion can provide comparable analgesiato epidural infusionin patients after laparotomy colorectal surgery and have less incidence of side-effect. |
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