Effects of Ropivacaine Combined with Ketorolac Transverse Abdominis Plane Block on Postoperative Analgesia in Patients Undergoing Gynecological Laparoscopic Surgery
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v2i3.470
Abstract
Objective — To observe the effects of ropivacaine combined with ketorolac transverse abdominis plane (TAP) block on postoperative analgesia in patients undergoing gynecological laparoscopic surgery. Methods — 90 ASAⅠorⅡpatients, aged 18-65 years and weighting 40-80 kg, scheduled for gynecological laparoscopic surgery were recruited and divided into three groups using random number table:ropivacaine combined with ketorolac 15 mg/side for TAP block (KR group), ropivacaine for TAP block and 30 mg preoperatively intravenous ketorolac (KIVR group) and ropivacaine for TAP block alone (R group) with 30 patients in each group. Intraoperative opioid consumption, Bruggrmann comfort scale (BCS) scores at 2h (T1), 4h (T2), 8h (T3), 12h (T4), 16h (T5), 24h (T6) after surgery were recorded. Adverse reactions such as nausea and vomiting, respiratory depression, local anesthetic poisoning, gastrointestinal bleeding, and complications related to TAP block operation were recorded. Results — The total consumpsion of sufentanil was higher in the R group than that in the KIVR group and KR group (P < 0.05). The total dosage of remifentanil in R group was higher than that in KR group (P < 0.05). The BCS scores of the three groups at T3, T4, T5 and T6 were lower in R group than that in KR group (P < 0.05) while R Group was lower than KIVR group at T3 and T4 (P < 0.05), and KIVR group was lower than KR group at T5 and T6. There was no statistically differences in BCS score between the three groups at T1 and T2 (P > 0.05). No statistical differences in the incidence of adverse reactions among all groups were observed. Conclusion — Ropivacaine combined with ketolorac transverse abdominisplane block reduced the intraoperative opioid consumption, improved postoperative comfort score and do not increased the incidence of adverse reactions in gynecological laparoscopic surgery.
Keywords
ketorolac, transverse abdominis plane block, ropivacaine, gynecological laparoscopic surgery, postoperative rehabilitation
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[2] JIANG Q, HUANG S Q, JIAO J, et al. Effect of the Combination of Ketorolac and Bupivacaine on Transversus Abdominis Plane Block for Postoperative Analgesia After Gynecological Laparoscopic Surgery [J]. Med Sci Monit, 2020, 26 (e925006.
[3] FANG X, ZHU T，MI W，et al. Ketorolac analgesia expert consensus [J]. Journal of Clinical Anesthesiology, 2019, 35 (3): 298-303.
[4] J.M.B.SMALLMAN, H.POWELL, M.C.EWART, et al. Ketorolac for postoperative analgesia in elderly patients [J]. Anaesthesia, 2016, 149-52.
[5] MCDONNELL J G, O'DONNELL B, CURLEY G, et al. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial [J]. Anesth Analg, 2007, 104 (1): 193-7.
[6] MCDONNELL J G, O'DONNELL B D, FARRELL T, et al. Transversus Abdominis Plane Block: A Cadaveric and Radiological Evaluation [J]. REGIONAL ANESTHESIA AND PAIN MEDICINE, 2007, 399-404.
[7] REINHART, DOUGLAS, J., et al. Postoperative Analgesia After Peripheral Nerve Block for Podiatric Surgery [J]. Regional Anesthesia and Pain Medicine, 2000, 25 (5): 506-13.
[8] CANSINO C, EDELMAN A, BURKE A, et al. Paracervical block with combined ketorolac and lidocaine in first-trimester surgical abortion: a randomized controlled trial [J]. Obstetrics & Gynecology, 2009, 114 (6): 1220-6.
[9] BASENKO I L, TCHUEV P N, BUDNYUK A A, et al. Use of Ketorolac as adjuvant in brachial plexus block with bupivacaine: A-472 [J]. European Journal of Anaesthesiology, 2006, 23 (Supplement 37).
[10] BARNEY E Z, PEDRO C D, GAMEZ B H, et al. Ropivacaine and Ketorolac Wound Infusion for Post-Cesarean Delivery Analgesia: A Randomized Controlled Trial [J]. Obstetrics and Gynecology, 2020, 135 (2): 427-35.
[11] MIRKHESHTI A, SAADATNIAKI A, SALIMI A, et al. Effects of dexmedetomidine versus ketorolac as local anesthetic adjuvants on the onset and duration of infraclavicular brachial plexus block [J]. Anesth Pain Med, 2014, 4 (3): e17620.
[12] CLERC S, VUILLEUMIER H, FRASCAROLO P, et al. Is the effect of inguinal field block with 0.5% bupivacaine on postoperative pain after hernia repair enhanced by addition of ketorolac or S (+) ketamine? [J]. Clinical Journal of Pain, 2005, 21 (1): 101-5.
[13] BEN. B, BAUNE. U, GOLDIK. Z, et al. Is preoperative ketorolac a useful adjunct to regional anesthesia for inguinal herniorrhaphy? [J]. Acta Anaesthesiologica Scandinavica, 1996, 358-63.
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