The analgesic effect of double injection technique intruncal block on the laparotomy of long duration

比较腹横肌平面（TAP）阻滞与连续硬膜外阻滞在妇科长时间开腹手术中的镇痛效果。术后72小时内，TAP阻滞和连续硬膜外阻滞的静息和咳嗽视觉模拟评分（VAS）无统计学差异。吗啡的总消耗量没有统计学差异。然后，我们比较了切口前TAP阻滞联合术后腹直肌鞘阻滞（双注射技术）与切口前TAP阻滞在长时间脓毒症剖腹术患者中的镇痛效果。我们还测定了罗哌卡因的血药浓度。两种注射技术在术后72小时内静息和咳嗽时的VAS无差异。吗啡的总消耗量没有差异。罗哌卡因的血药浓度保持在引起局部麻醉毒性的水平以下。

We compared the analgesic effect of the transversus abdominis plane (TAP) block with that of continuous epidural block in patients undergoing gynecological laparotomy of long duration. The visual analogue scales (VAS) at rest and at cough during the postoperative 72 hours were not statistically different between TAP block and continuous epidural block. The total consumption of morphine was not statistically different. Then, we compared the analgesic effect of pre-incisional TAP block combined postoperative rectus sheath block (double injection technique) with that of pre-incisional TAP block in patients undergoing pynecological laparotomy of long duration. We also measured the blood concentration of ropivacaine. The VAS at rest and cough during the postoperative 72 hours were not different between the two injection techniques. The total morphine consumption was not different. The blood concentrations of ropivacaine were kept below the level causing local anesthetic toxicity.