Surgical laparoscopy, endoscopy & percutaneous techniques · 2025
Rectus Sheath and Transversus Abdominis Plane Blocks for Preaponeurotic Endoscopic Repair: Is the Double Block the Solution for Postoperative Pain Management?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Toscano Antonio, Bonomo Luca Domenico, Capuano Paolo, Cremascoli Luca, Castelli Filippo, Puppo Mattia, Aprà Fabrizio, Jannaci Alberto, Cuccomarino Salvatore
Аннотация
BACKGROUND: Diastasis recti abdominis (DRA) is a prevalent postpartum condition characterized by the separation of the rectus abdominis muscles with an interrectal distance >2.5 cm, often leading to symptoms like back pain, constipation, and urinary incontinence. Preaponeurotic endoscopic repair (REPA) is a novel, minimally invasive surgical approach for DRA, offering an alternative to traditional abdominoplasty. Despite its minimally invasive nature, REPA surgery poses significant postoperative pain challenges, typically managed with opioids, which carry numerous side effects.
MATERIALS AND METHODS: This retrospective study evaluates the efficacy of combining 2 ultrasound-guided abdominal wall blocks, rectus sheath block (RSB) and transversus abdominis plane block (TAPB), to manage postoperative pain in 55 DRA patients who underwent REPA surgery. We performed lateral TAPB in 28 cases, whereas 27 received an association of TAPB and RSB.
RESULTS: At 6 hours postsurgery, 61% of patients in the TAPB group reported significant pain (Numeric Rating Scale >3), compared with 19% in the TAPB-RSB group ( P = 0.001). The TAPB-RSB group also required fewer analgesic rescue doses ( P = 0.042) and showed earlier recovery, with faster initiation of oral intake and mobility.
CONCLUSION: The combination of TAPB and RSB significantly reduces opioid consumption, postoperative pain, and the need for rescue analgesia compared with TAPB alone. The dual-block approach, providing a multi-dermatomal sensory block, suggests a promising strategy for improving postoperative pain management in REPA surgery.
MATERIALS AND METHODS: This retrospective study evaluates the efficacy of combining 2 ultrasound-guided abdominal wall blocks, rectus sheath block (RSB) and transversus abdominis plane block (TAPB), to manage postoperative pain in 55 DRA patients who underwent REPA surgery. We performed lateral TAPB in 28 cases, whereas 27 received an association of TAPB and RSB.
RESULTS: At 6 hours postsurgery, 61% of patients in the TAPB group reported significant pain (Numeric Rating Scale >3), compared with 19% in the TAPB-RSB group ( P = 0.001). The TAPB-RSB group also required fewer analgesic rescue doses ( P = 0.042) and showed earlier recovery, with faster initiation of oral intake and mobility.
CONCLUSION: The combination of TAPB and RSB significantly reduces opioid consumption, postoperative pain, and the need for rescue analgesia compared with TAPB alone. The dual-block approach, providing a multi-dermatomal sensory block, suggests a promising strategy for improving postoperative pain management in REPA surgery.