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Published on: June 25, 2013
Effect of ultrasound-guided bilateral rectus sheath block on postoperative pain control after robotic single-site
Sooyoung Cho1, Sooyoung Cho2, Youn Jin Kim1
1Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
Purpose:
Rectus sheath block (RSB) is a simple abdominal wall block that can be readily applied. This study evaluated the postoperative analgesic efficacy of ultrasound-guided bilateral RSB in robotic single-site gynecologic surgery.
Methods:
Sixty patients were randomly assigned to the RSB group (n=30) or the control group (n=30). After induction of general anesthesia, patients in the RSB group received ultrasound-guided bilateral RSB with 30 mL of 0.25% ropivacaine. Pain intensity was assessed using a verbal numerical rating scale (VNRS) at 0, 1, 6, 12, 24, and 48 hours postoperatively. Intravenous patient-controlled analgesia was provided to all patients, and fentanyl was administered as rescue analgesia on request.
Results:
VNRS scores at 0, 1, and 6 hours were significantly lower in the RSB group than in the control group (all P<0.05). Rescue fentanyl use in the post-anesthesia care unit was also significantly lower in the RSB group than in the control group (19.8±21.0 μg vs. 46.3±27.6 μg, P<0.001). Subgroup analysis showed that RSB was associated with lower VNRS scores in patients undergoing ovarian surgery or myomectomy, whereas no significant difference was observed in patients undergoing hysterectomy.
Conclusion:
Ultrasound-guided bilateral RSB reduced early postoperative pain and rescue analgesic requirements after robotic single-site gynecologic surgery.
