Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2023; 15(10): 2171-2178
Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2171
Analgesic effect of ultrasound-guided bilateral transversus abdominis plane block in laparoscopic gastric cancer
Ya-Ya Wang, Hua-Jun Fu
Ya-Ya Wang, Hua-Jun Fu, Department of Anesthesiology, Shaanxi Provincial People’s Hospital, Xi'an 710068, Shaanxi Province, China
Author contributions: Wang YY initiated the project and designed the experiment, wrote the original manuscript, performed postoperative follow-up, and recorded data; Fu HJ conducted a number of collations, conducted clinical data collection and statistical analysis, and revised the paper; both authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Shaanxi Provincial People's Hospital, and the Ethics Committee also agreed to waive the requirement for informed consent.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua-Jun Fu, MM, Doctor, Department of Anesthesiology, Shaanxi Provincial People’s Hospital, No. 256 Youyi West Road, Xi'an 710068, Shaanxi Province, China. fuhuajun497055726@163.com
Received: June 14, 2023
Peer-review started: June 14, 2023
First decision: July 3, 2023
Revised: July 21, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: October 27, 2023
Abstract
BACKGROUND

Postoperative complications are important factors affecting the survival time and quality of life of patients undergoing radical gastrectomy.

AIM

To investigate and compare the anesthetic effects of intravenous general anesthesia combined with epidural anesthesia or ultrasound-guided bilateral transversus abdominal plane block (TAPB) in gastric cancer patients undergoing laparoscopic radical gastrectomy.

METHODS

The clinical data of 85 patients who underwent laparoscopic radical gastrectomy in our hospital from December 2020 to January 2023 were retrospectively collected and divided into a TAPB group (n = 45) and epidural anesthesia group (n = 40) according to the different anesthesia and analgesia programs used. The TAPB group received general anesthesia combined with TAPB, and the epidural anesthesia group received general anesthesia combined with epidural anesthesia. The pain status, cognitive status, intestinal barrier indicators, recovery quality, and incidence of complications were compared between the two groups.

RESULTS

Compared with the epidural anesthesia group, the TAPB group’s visual analog scale scores were significantly lower 6 h, 12 h, 24 h and 48 h after surgery (P < 0.05). The incidence of postoperative cognitive dysfunction (POCD) in the TAPB group was significantly lower than that in the epidural anesthesia group, and the Mini-mental State Examination score 24 h after surgery was significantly higher in the TAPB group than the epidural anesthesia group (P < 0.05). The levels of diamine oxidase and plasma D-lactate were significantly lower in the TAPB group than the epidural anesthesia group 24 h after surgery (P < 0.05). The agitation score and the incidence of agitation during recovery were significantly lower in the TAPB group than epidural anesthesia group (P < 0.05). The total incidence of postoperative complications in the TAPB group was 4.44%, significantly lower than the 20.00% in the epidural anesthesia group (P < 0.05).

CONCLUSION

Compared with epidural anesthesia combined with general anesthesia, TAPB combined with general anesthesia had a good analgesic effect in laparoscopic radical gastrectomy and can further reduce the incidence of POCD and postoperative complications, improve the levels of intestinal barrier indicators, and improve postoperative recovery quality.

Keywords: Laparoscopic radical gastrectomy, Ultrasound-guided bilateral transversus abdominal plane block, Cognitive impairment, Intestinal barrier function

Core Tip: As an important part of surgical treatment, anesthesia significantly impacts the incidence of postoperative complications. In this study, the anesthetic effects of intravenous general anesthesia combined with epidural anesthesia or ultrasound-guided bilateral transversus abdominal plane block (TAPB) in patients with laparoscopic gastric cancer were compared. The results showed that, compared with epidural anesthesia combined with general anesthesia, TAPB combined with general anesthesia had better analgesic effects in laparoscopic gastric cancer surgery and could further reduce the incidence of postoperative cognitive dysfunction and postoperative complications, improve the levels of intestinal barrier index, and improve the quality of postoperative recovery.