The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

Abstract

Background: Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery. Methods: A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine/ morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and offbed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded. Results: Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores. Conclusions: The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery.

Preoperative versus postoperative ultrasound-guided rectus sheath block for acute postoperative pain relief after laparoscopy: A retrospective cohort study

“…[1] RSB is performed for umbilical and periumbilical sites and is effective in reducing umbilical incisional pain during and after surgery. [4,5] Moreover, RSB can be used Medicine with abdominal ultrasound because it is associated with fewer complications. [4] At our institution, we perform ultrasound-guided RSB before or after surgery.…”

Effect of Rectus Sheath Block on Postoperative Quality of Recovery After Transabdominal Midline Gynecological Surgery: A Randomized Controlled Trial

“… 3 , 4 RSB provides analgesia effect for a midline incision by blocking the 7th to 11th intercostal nerves’ terminal branches within the rectus sheath. 5 Clinical studies have shown efficacy in sparing opioid consumption and accelerating recovery following RSB in laparoscopic surgery, however there are limited data on the quality of recovery after transabdominal midline gynecological surgery. 3 , 4 This randomized controlled study looks forward to bring new ideas for postoperative recovery in this kind of surgery.…”