Effectiveness of ultrasound-guided transversus abdominis plane block and rectus sheath block in pain control and recovery after gynecological transumbilical single-incision laparoscopic surgery

Clin Exp Obstet Gynecol. 2014;41(6):627-32.

Abstract

Purpose: To evaluate the effectiveness of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks in pain management and recovery after gynecological single-incision laparoscopic surgery (SILS).

Materials and methods: Abilateral TAP block (Group A, n = 9), bilateral TAP and RS blocks (Group B, n = 10), and a bilateral RS block (Group C, n = 9) with 40 ml ropivacaine per patient were conducted in 28 patients undergoing SILS for ovarian tumors. A pain score and walking distance in a 6-minute walk test (6MWT) were examined.

Results: Pain scores were significantly lower on postoperative day (POD) 3 than on POD 1 in Groups B (p = 0.03) and C (p = 0.02). The walking distance on POD 3 was comparable with that before surgery in Group C (p = 0.75), but shorter in Groups A (p = 0.004) and B (p = 0.02).

Conclusions: The RS block alone was the most effective in relieving pain and accelerating general recovery after gynecological SILS.

MeSH terms

  • Abdominal Muscles / innervation*
  • Adult
  • Female
  • Gynecologic Surgical Procedures*
  • Humans
  • Laparoscopy*
  • Middle Aged
  • Nerve Block / methods*
  • Pain, Postoperative / therapy*
  • Rectus Abdominis / innervation
  • Ultrasonography, Interventional / methods*