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- Title
Addition of preoperative transversus abdominis plane block to multimodal analgesia in open gynecological surgery: a randomized controlled trial.
- Authors
Geng, Zhi Yu; Zhang, Yan; Bi, Hui; Zhang, Dai; Li, Zheng; Jiang, Lu; Song, Lin Lin; Li, Xue Ying
- Abstract
Background: Transversus abdominis plane (TAP) block can provide effective analgesia for abdominal surgery. However, it was questionable whether TAP had additional effect in the context of multimodal analgesia (MMA). Therefore, this study aimed to assess the additional analgesic effect of preoperative TAP block when added to MMA protocol in open gynecological surgery. Methods: In this prospective, randomized-controlled trial, 64 patients scheduled for open gynecological surgery were randomized to receive preoperative TAP block (Study group, n = 32) or placebo (Control group, n = 32) in addition to MMA protocol comprising dexamethasone, acetaminophen, flurbiprofen and celecoxib, and rescued morphine analgesia. The primary outcome was rescued morphine within 24 h after surgery. Secondary outcomes included pain scores, adverse effects, quality of recovery measured by 40-item quality of recovery questionnaire score (QoR-40) at 24 h, and quality of life measured with short-form health survey (SF − 36) on postoperative day (POD) 30. Results: The Study group had less rescued morphine than the control group within 24 h [5 (2–9) vs. 8.5 (5–12.8) mg, P = 0.013]. The Study group had lower pain scores at 1 h [3 (2–4) vs. 4 (3–5), P = 0.007], 2 h [3 (2–4) vs. 3.5 (3–5), P = 0.010] and 6 h [3 (2–3) vs. 3 (2.3–4), P = 0.028], lower incidence of nausea at 48 h (25.8% vs. 50%, P = 0.039), and higher satisfaction score [10 (10–10) vs. 10 (8–10), P = 0.041]. The SF-36 bodily pain score on POD 30 was higher in the Study group (59 ± 13 vs. 49 ± 16, P = 0.023). Conclusions: Preoperative TAP block had additional analgesic effect for open gynecological surgery when used as part of multimodal analgesia. Rescued morphine within 24 h was significantly reduced and the SF-36 bodily pain dimension at 30 days after surgery was significantly improved. Trial registration: www.chictr.org.cn (ChiCTR2000040343, on Nov 28 2020).
- Subjects
CHINA; PREOPERATIVE care; DRUG repositioning; CYCLOOXYGENASE 2; FEMALE reproductive organ diseases; TRANSVERSUS abdominis muscle; ANALGESIA; ACADEMIC medical centers; PAIN measurement; ANESTHESIA; DEXAMETHASONE; ACETAMINOPHEN; NONSTEROIDAL anti-inflammatory agents; NERVE block; TERTIARY care; HEALTH surveys; GYNECOLOGIC surgery; TREATMENT effectiveness; RANDOMIZED controlled trials; MORPHINE; ABDOMINAL surgery; QUESTIONNAIRES; BLIND experiment; DESCRIPTIVE statistics; QUALITY of life; COMBINED modality therapy; STATISTICAL sampling; FLURBIPROFEN; LONGITUDINAL method; EVALUATION
- Publication
BMC Anesthesiology, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2253
- Publication type
Article
- DOI
10.1186/s12871-023-01981-w