Background: Peritoneal dialysis catheter placement can be performed under general anesthesia, local anesthesia or subarachnoid anesthesia (SA). Recently, studies have reported the successful placement of peritoneal dialysis catheters using a transversus abdominis plane (TAP) block and rectus sheath (RS) block. This study compared the TAP + RS block with SA for patients undergoing peritoneal dialysis catheter placement. Methods: Sixty patients were randomly divided into two groups, with 30 receiving unilateral ultrasound-guided TAP + RS block anesthesia and 30 receiving SA. The demographic characteristics, anesthesia efficacy, indicators related to anesthesia or operation, hemody-namic index, postoperative pain numeric rating score (NRS), postoperative recovery indica-tors, complications related to anesthesia or surgery, and dosage of sedative or analgesic medication were analyzed. Results: Anesthesia operation time was significantly shorter in the TAP + RS block group than in the SA group (P<0.001), while there was no significant difference in success rates (TAP + RS 93.33% [95% confidence interval, 95% CI, 83.9–102.8%] vs SA 100.00% [95% CI, 100–100%], P=0.472). Two patients in the TAP + RS group needed extra analgesia, although the dermatome pinprick sensation test gave negative results for all patients. Patients who received the TAP + RS block expressed significantly less pain on movement or at rest at 4 h and 8 h postoperative. Fewer patients needed rescue analgesia with tramadol in the postoperative period in the TAP + RS block group than in the SA group (P<0.05). The intraoperative MAP was more stable (P<0.05) in the TAP + RS group compared to the SA group. Conclusion: The TAP + RS block is a safe, effective method for use as the principal anesthesia technique in PD catheter placement. Compared to SA, it has the advantages of less influence on hemodynamics and a better postoperative analgesic effect.
CITATION STYLE
Li, J., Guo, W., Zhao, W., Wang, X., Hu, W., Zhou, J., … Lei, H. (2020). Ultrasound-guided unilateral transversus abdominis plane combined with rectus sheath block versus subarachnoid anesthesia in patients undergoing peritoneal dialysis catheter surgery: A randomized prospective controlled trial. Journal of Pain Research, 13, 2279–2287. https://doi.org/10.2147/JPR.S264255
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