Key result
Ultrasound-guided posterior transversus abdominis plane block with rectus sheath block significantly reduced postoperative sufentanil consumption at 0-24 hours compared to placebo (37.5 µg vs 80.0 µg, p<0.01) in patients undergoing laparoscopy-assisted radical resection of rectal cancer.
Why the study?
Many patients experience pain after laparoscopic surgery, but the analgesic effects of combining ultrasound-guided posterior TAPB with RSB after laparoscopy-assisted radical resection of early-stage rectal cancer required investigation.
Does ultrasound-guided posterior TAPB with RSB reduce postoperative opioid use in adults undergoing laparoscopy-assisted radical resection of rectal cancer?
RCT (n=78)
Double-blind
Computerized random number generator
No
Does ultrasound-guided posterior TAPB with RSB reduce postoperative opioid use in adults undergoing laparoscopy-assisted radical resection of rectal cancer?
Absolute Event Rate: 37.5% vs 80%
p-value: p=<0.01
Ultrasound-guided posterior TAPB combined with RSB significantly reduces postoperative opioid consumption compared to TAPB alone or placebo in patients undergoing laparoscopy-assisted radical resection of rectal cancer.
Combined TAPB+RSB reduces opioid use after laparoscopic rectal resection; extends RCT evidence for combined abdominal wall blocks in colorectal surgery.
BackgroundMany patients complain of pain following laparoscopic surgery. Clinicians have used ultrasound-guided posterior transversus abdominis plane block (TAPB) and rectus sheath block (RSB) for multimodal analgesia after surgery. We investigated the analgesic effects of US-guided posterior TAPB with RSB on postoperative pain following laparoscopy-assisted radical resection of early-stage rectal cancer.MethodsSeventy-eight adults scheduled for laparoscopy-assisted radical resection of rectal cancer were enrolled in this double-blind placebo-controlled trial. Patients were randomized into 3 groups: the TR Group underwent US-guided bilateral posterior TAPB (40 mL 0.33% ropivacaine) with RSB (20 mL 0.33% ropivacaine); the T Group underwent US-guided bilateral posterior TAPB alone; and the Control Group received saline alone. All patients also had access to patient-controlled intravenous analgesia (PCIA) with sufentanil. The primary outcome was postoperative sufentanil consumption at 0–24, 24–48, and 48–72 h. The secondary outcomes were postoperative pain intensity and functional activity score at rest and while coughing for the same three time periods, intraoperative medication dosage, use of rescue analgesia, recovery parameters, and adverse effects.ResultsThe three groups had no significant differences in baseline demographic and perioperative data, use of intraoperative medications, recovery parameters, and adverse effects. The TR group had significantly lower postoperative use of PCIA and rescue analgesic than in the other two groups (P < 0.05), but the Control Group and T Group had no significant differences in these outcomes.ConclusionsPostoperative US-guided posterior TAPB with RSB reduced postoperative opioid use in patients following laparoscopy-assisted radical resection of rectal cancer.Trial registrationThe trial was registered with chictr.org (ChiCTR2000029326) on January 25, 2020.
No takes yet. Share an insight, caveat, or question.
Liang et al. (2020) conducted an RCT in Early-stage rectal cancer (n=78). Ultrasound-guided posterior transversus abdominis plane block with rectus sheath block vs. Placebo (saline) or TAPB alone was evaluated on Postoperative sufentanil consumption at 0-24 hours (µg) (p=<0.01). Ultrasound-guided posterior transversus abdominis plane block with rectus sheath block significantly reduced postoperative sufentanil consumption at 0-24 hours compared to placebo (37.5 µg vs 80.0 µg, p<0.01) in patients undergoing laparoscopy-assisted radical resection of rectal cancer.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: