J. Nagata1, Y. Sawatsubashi1, M. Akiyama1, Y. Akiyama2, K. Arase2, N. Minagawa2, T. Torigoe2, Y. Nakayama1, K. Hirata2 1Wakamatsu Hospital Of University Of Occupational And Environmental Health, Japan,Surgery,Kitakyushu, FUKUOKA, Japan 2University Of Occupational And Environmental Health, Japan,Surgery,Kitakyushu, FUKUOKA, Japan
Introduction: Ultrasound-guided percutaneous rectus sheath block and transversus abdominis plane block have become increasingly popular and used to provide analgesia for laparoscopic surgery. We report a novel transperitoneal approach of analgesia for laparoscopic abdominal surgery.
Methods: Observation was performed retrospectively. Two groups were compaired. One is the group with only conventional anesthesia, and the other was patients with novel nerve block. Under general anesthesia, a laparoscopic puncture needle was inserted via 3 or 5mm abdominal port, and 10 – 20mL levobupivacaine was injected into the correct plane through the peritoneum. This procedure was performed under combined images of laparoscopy and ultrasound. Postoperatively, the patient’s pain intensity assessed by the numeric rating scale.
Results: A total of 100 consecutive patients were enrolled. Colorectal surgery was 50 cases, gastric surgery was 15 cases, repair of inguinal hernia was 25 cases and other was 10. All operation was performed successfully and a novel laparoscopic anesthesia did not prevent completing operative procedure. Postoperatively, the patient’s mean pain intensity by the scale was measured. Numeric rating scale was smaller in the group of novel anesthesia (0.4 vs 0.8 at 6hrs postoperative on moving, p=0.29). Total volume of intravenous fentanyl?(10mL vs 5mL/2days) and frequency of pain killer was reduced?(1.5 vs 2.8?times/day, p=0.03). The mean time of novel block technique was 4.5 minutes
Conclusion: This novel analgesia technique would be considered as an optional regimen in laparoscopic surgery. Additional prospective studies are required to evaluate the benefit of this new laparoscopic block.