Bilateral Rectus Sheath Block with Continuous Bupivacaine Infusions After Elective Open Gastrectomy: A Randomized...

Area of Science:

• Anesthesiology
• Surgical Recovery
• Pain Management

Background:

• Multimodal analgesia aids early recovery and gastrointestinal function post-gastrectomy.
• Open gastrectomy patients can experience significant postoperative pain and delayed rehabilitation.

Purpose of the Study:

• To evaluate the efficacy of bilateral rectus sheath block (RSB) with continuous bupivacaine infusion.
• To compare RSB with continuous bupivacaine infusion against a placebo in open gastrectomy patients.

Main Methods:

• A randomized clinical trial involving 60 patients undergoing elective open gastrectomy.
• Patients received either continuous bupivacaine infusion via bilateral RSB (Group A) or a saline placebo (Group B).
• Primary outcomes included opioid consumption and visual analogue scale (VAS) pain scores within 72 hours post-surgery.

Main Results:

• Group A patients reported significantly lower median VAS pain scores (p < 0.001).
• No patients in Group A required rescue opioid analgesia; NSAIDs were used in the initial 12 hours.
• Group A demonstrated significantly shorter times to first flatus (p = 0.001), bowel movement (p < 0.001), and out-of-bed activity (p < 0.001).
• Overall hospital stay was significantly shorter for Group A patients (p < 0.001).

Conclusions:

• Bilateral RSB with continuous bupivacaine infusion is an effective strategy for postoperative pain management.
• This technique reduces opioid analgesic requirements and promotes accelerated recovery.
• The intervention leads to a shorter duration of hospitalization for patients undergoing open gastrectomy.