Abstract
Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incisional pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, and butorphanol for postoperative analgesia in patients undergoing SILC.Methods: All patients who met the criteria were randomly divided into four groups: group I, (n=29) patient-controlled intravenous analgesia (PCIA) (sufentanil 1 µg/ml); group II, (n=29) PCIA (butorphanol 0. 08 µg/ml); group III, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (sufentanil 1 µg/ml); and group IV, (n=29) ultrasound-guided RSB (ropivacaine 100 mg) combined with PCIA (butorphanol 0.08 µg/ml). General anesthesia in all groups, It's noteworthy that we only use general anesthesia, not ultrasound-guided RSB in group I and II. The primary outcome were numeric rating scale (NRS) scores (0-10) of incisional pain and visceral pain. Secondary outcomes were the dose of butorphanol and sufentanil, the number of PCIA presses, the length of hospital stay and the incidence of postoperative adverse events.
Results: Both the rest and cough incisional pain scores were lower during the first 2, 6 and 12 h in group Ⅲ than in group Ⅰ (P＜0.05). Similarly, scores in group Ⅳ were significantly lower than those in group II (P＜0.05). The NRS scores for visceral pain were lower in group II at 2, 6 and 12 h after surgery than in group I (P＜0.05) and lower in group IV than in group Ⅲ (P＜0.05). Patients in group I needed more butorphanol as a rescue analgesic for pain relief than did those in group III, and patients in group IV needed less butorphanol as a rescue analgesic for pain relief than did those in group II. From the above pairwise comparisons, it is clear that groups III and IV had lower NRS scores. Overall, ultrasound-guided RSB combined with PCIA (butorphanol 0. 08 µg/ml) performed the best.
Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC than can general anaesthesia combined with sufentanil.
A Comparative Study of Ultrasound Guided Bilateral Rectus Sheath Block versus Local Incision Site Infiltration for Post Operative Analgesia in Patients Undergoing Laparotomy with Midline Incision