Online ISSN: 2515-8260

Comparison between oblique subcostal transversus abdominis plane block and rectus sheath block for midline incision abdominal surgeries

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1Vigya Goyal, 2 Saravjot Kaur Sandhu, 3Vishnu Kumar Garg, 4Khayyam, 5 Sudhir Sachdev, 6Durga Jethava

Abstract

Background: Epidural analgesia remains the gold standard for pain control for abdominal surgical procedures, yet have many potential side effects, risks and limitations. The idea of oblique subcostal transversus abdominis plane block (OSTAPB) and rectus sheath block (RSB) is to anesthetize part of or the entire abdominal wall instead of using intrathecal or epidural techniques, especially in the presence of sepsis and coagulopathy. Materials and methods: 60 patients scheduled for midline incision abdominal surgeries were randomly assigned to receive ultrasound-guided RSB and OSTAPB blocks with 20ml 0.25% bupivacaine and 40ml 0.25% bupivacaine respectively on each side after induction with general anaesthesia and before start of surgery. Preoperative and intraoperative parameters, plus intraoperative and postoperative cumulative analgesic consumption were recorded. Both groups received intravenous paracetamol 15mg/kg 8 hourly. Postoperative pain severity was assessed using 10cm VAS score and time to request for rescue analgesia, total analgesic consumption in 24 h were recorded. Results: Patients in the OSTAPB group had more stable hemodynamics and consumed statistically significant less opioid in comparison to RSB group either intraoperatively or postoperatively. Mean VAS scores were statistically significant less in OSTAPB group than in the RSB group at 0, 2, 6, 12, and 24 h postoperatively. More patients’ satisfaction was reported in the OSTAPB Group

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