Research on the efficacy of the rectus sheath block method

Amaç & Hipotez:Objectives: We aimed to retrospectively investigate the efficacy of ultrasound guided rectus sheath block (RSB) method in our study.

📊

Temel Bulgular & Veri:Methods: We scanned 235 patient files operated for abdominal pathology.

💡

Sonuç & Katkı:Conclusion: Ultrasound guided rectus sheath block is an effective method for postoperative pain control.

🔬Tür:Araştırma Makalesi

📍Kapsam:Genişletilmiş Akademik Örneklem

⚙️Değişkenler:Alan Parametreleri

Özet

Objectives: We aimed to retrospectively investigate the efficacy of ultrasound guided rectus sheath block (RSB) method in our study. Methods: We scanned 235 patient files operated for abdominal pathology. Patients meeting the criteria were evaluated for intra-operative rectus sheath block and two different groups were formed. In these two groups of patients visual analogue scale (VAS) values recorded from the postoperative pain follow-up form and analgesic delivery (DEL) and analgesic demand (DEM) values recorded from patient controlled analgesia (PCA) device were compared. In addition, complaints of nausea, vomiting and constipation were evaluated. Results: Postoperative VAS values (Postoperative 1, 12 and 24 hours p<0.001), DEM values (Postoperative 1, 12 and 24 hours p<0.001) and total amount of morphine consumed (Postoperative 1, 12 and 24 hours p<0.001) were lower in patients with RSB. Also, in patients with RSB nausea (p=0.014) and vomiting was less seen postoperatively (p=0.007). In the first 24 hours after surgery, constipation was seen in 8 patients with RSB and constipation was seen in 30 patients without RSB (p=0.00). Conclusion: Ultrasound guided rectus sheath block is an effective method for postoperative pain control.

Abstract

Amaç: Çalışmamızda ultrasonografi eşliğinde yapılan rektus kılıf bloğu (RKB) yönteminin etkinliğini retrospektif olarak araştırmayı amaçladık. Gereç ve Yöntem: Abdominal patoloji nedeniyle ameliyat olmuş 235 hasta dosyasını taradık. Kriterleri karşılayan hastalar intraoperatif RKB yapılması yönünden değerlendirildi ve RKB yapılan ve yapılmayan olarak iki farklı grup oluşturuldu. Belirlenen bu iki grup hastada postoperatif ağrı takip formuna kaydedilmiş olan vizuel analog skala (VAS) değeri ve hasta kontrollü analjezi (HKA) cihazından kaydedilmiş olan analjezik sunumu (DEL) ve analjezik isteği (DEM) değerleri karşılaştırıldı. Ayrıca hastanın ifade etmiş olduğu bulantı, kusma ve kabızlık şikayetleri değerlendirildi. Bulgular: Postoperatif VAS değerleri (postoperatif 1, 12, 24. saat p<0.001), DEM değerleri (postoperatif 1, 12 ve 24. saat p<0.001) ve tüketilen toplam morfin miktarları (postoperatif 1, 12 ve 24. saat p<0.001) RKB yapılmış hastalarda daha düşüktü. Ayrıca, RKB yapılmış hastalarda postoperatif bulantı (p=0.014) ve postoperatif kusma daha az idi (p=0.007). Cerrahi sonrası ilk 24 saatte RKB uygulanmış 8 hastada, RKB uygulanmamış 30 hastada kabızlık görüldü (p=0.00). Sonuç: Ultrasonografi eşliğinde yapılan RKB orta hat kesisi ile gerçekleştirilen batın ameliyatlarında postoperatif ağrı kontrolünde etkili bir yöntemdir.

🔖

Bu Makaleye Atıf Yap

KARAARSLAN, E., TOPAL, A., AVCI, O., UZUN, S. T. (2018). Research on the efficacy of the rectus sheath block method. Ağrı, Cilt: 30 - Sayı: 4, 183–188. https://ajindex.com/articles/146456

📄 Tam Metin PDF Okuyucu

Yeni Sekmede Aç ↗

↗Yeni Sekme

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (11)

Cousins MJ. Acute and postoperative pain. In: Wall PD, Melzack R, editors. Textbook of Pain. 3th. New York: Livingstone Inc; 1994. p. 357–85.
Pasero C, McCaffery M. Postoperative pain management in the elderly. Seattle: IASP Press; 1996. p. 45–68. Aydınlı I. Geriatrik olgularda postoperatif ağrı tedavisi. T Klinik Anest Reanim 2003;1:47–58.
Engelhardt T, Steel E, Johnston G, Veitch DY. Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine. Paediatr Anaesth 2003;13(3):249–52.
Howard R, Carter B, Curry J, Morton N, Rivett K, Rose M, Tyrrell J, et al.; Association of Paediatric Anaesthetists of Great Britain and Ireland. Postoperative pain. Paediatr Anaesth 2008;18 Suppl 1:36–63.
Wong I, St John-Green C, Walker SM. Opioid-sparing effects of perioperative paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in children. Paediatr Anaesth 2013;23(6):475–95. Bailey PL. Stanley TH. Intravenous opioid anesthetics. In: Miller RD edıtor. Anaesthesia. 4th. Churchill Livingstone; 1994. p. 291-388.
Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg 1993;77(5):1048–56. Kehlet H. Controlling acute pain-role of preemptive analgesia, peripheral treatment and balanced analgesia and effects on outcome. In: M Mitchell, editor. Pain 1999-an updated review. Seattle: IASP Pres; 1999. p. 459–62.
Gelfand HJ, Ouanes JP, Lesley MR, Ko PS, Murphy JD, Sumida SM, et al. Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis. J Clin Anesth 2011;23(2):90–6.
Isaac LA, McEwen J, Hayes JA, Crawford MW. A pilot study of the rectus sheath block for pain control after umbilical hernia repair. Paediatr Anaesth 2006;16(4):406–9.
Gurnaney HG, Maxwell LG, Kraemer FW, Goebel T, Nance ML, Ganesh A. Prospective randomized observer-blinded study comparing the analgesic efficacy of ultrasound-guided rectus sheath block and local anaesthetic infiltration for umbilical hernia repair. Br J Anaesth 2011;107(5):790–5.
Wada M, Kitayama M, Hashimoto H, Kudo T, Kudo M, Takada N, et al. Brief reports: plasma ropivacaine concentrations after ultrasound-guided rectus sheath block in patients undergoing lower abdominal surgery. Anesth Analg 2012;114(1):230–2.
Dolan J, Lucie P, Geary T, Smith M, Kenny GN. The rectus sheath block: accuracy of local anesthetic placement by trainee anesthesiologists using loss of resistance or ultrasound guidance. Reg Anesth Pain Med 2009;34(3):247–50. Marh