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Ultrasound-guided Transversus Abdominis Plane Block is Effective as Laparoscopic Trocar site infiltration in Postoperative Pain Management in Patients Undergoing Adrenal Surgery.
Cavallaro, Giuseppe; Gazzanelli, Sergio; Iossa, Angelo; De Angelis, Francesco; Fassari, Alessia; Micalizzi, Alessandra; Petramala, Luigi; Crocetti, Daniele; Circosta, Francesco; Concistrè, Antonio; Letizia, Claudio; De Toma, Giorgio; Polistena, Andrea.
Afiliación
  • Cavallaro G; Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy.
  • Gazzanelli S; Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy.
  • Iossa A; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
  • De Angelis F; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
  • Fassari A; Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy.
  • Micalizzi A; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
  • Petramala L; Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
  • Crocetti D; Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy.
  • Circosta F; Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
  • Concistrè A; Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
  • Letizia C; Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
  • De Toma G; Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy.
  • Polistena A; Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy.
Am Surg ; 89(11): 4401-4405, 2023 Nov.
Article en En | MEDLINE | ID: mdl-35797715
BACKGROUND: Pain management in patients undergoing laparoscopy is still a matter of debate as several techniques have been proposed to reduce postoperative analgesic consumption and improve recovery. Among these, transversus abdominis plane (TAP) block is considered as safe, effective, and easy to perform under ultrasound guidance; even so, recently laparoscopically guided trocar site anesthetic infiltration has been proposed as a "surgeon-dependent alternative to TAP block." The aim of this evaluation is to compare these analgesic techniques in the setting of laparoscopic adrenalectomy. METHODS: This is a retrospective evaluation of a prospectively maintained database. Patients were divided into two groups: Group A patients received laparoscopic-assisted trocar site infiltration of ropivacaine; Group B patients received bilateral ultrasound-guided TAP block with ropivacaine. All patients received 24 h infusion of 20 mg morphine postoperatively; pain was checked at 6, 24 and 48 h after surgery. A rescue analgesia was given if numerical rating scale (NRS) score was > 4 or on patient request. RESULTS: One hundred and three patients were enrolled in the evaluation (57 in group A and 46 in group B). There were no differences in operative time, complications and postoperative stay, and no complications related to trocar site infiltration. There were no differences in NRS at 6, 24, and 48 hours as well as in patients requiring further analgesic administration. CONCLUSIONS: Laparoscopic-guided trocar site ropivacaine infiltration has similar pain outcomes compared to ultrasound-guided TAP block in the management of postoperative pain in patients undergoing laparoscopic adrenalectomy. Since there is no difference among these techniques, the decision can be based on surgeon or anesthesiologist preference.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Anestésicos Locales Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Am Surg Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Anestésicos Locales Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Am Surg Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos