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ORIGINAL RESEARCH article

Front. Pain Res.
Sec. Abdominal and Pelvic Pain
Volume 5 - 2024 | doi: 10.3389/fpain.2024.1454665

Rescue Analgesia with Transversus Abdominis Plane Block Improves Moderate-to-Severe Pain and Oxygenantion after Abdominal Surgery: A Randomized Controlled Trial

Provisionally accepted
Jingxian He Jingxian He Yuwen Wang Yuwen Wang Shuai Qin Shuai Qin Qiuping Ye Qiuping Ye Penglei Wang Penglei Wang Ye Zhang Ye Zhang *Yun Wu Yun Wu *
  • Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China

The final, formatted version of the article will be published soon.

    Background: Abdominal surgery is a common surgical procedure that is frequently associated with substantial postoperative pain. However, rescue analgesia using opioids is associated with several adverse effects. The transversus abdominis plane block (TAPB) has been demonstrated to be effective as part of multimodal analgesia. This study aimed to evaluate the effects of rescue analgesia using TAPB after abdominal surgery. Methods: Ninety patients undergoing abdominal surgery and reporting a numeric rating scale (NRS) score of cough pain ≥4 on the first postoperative day were randomized to receive either sufentanil or TAPB for rescue analgesia. Pain scores and arterial oxygen pressure (PaO2) were evaluated before and after administration of rescue analgesia. Sleep quality and gastrointestinal function were assessed postoperatively. The primary outcome was the degree of pain relief on coughing 30 min after rescue analgesia. Results: Patients reported a significantly reduced NRS score on coughing 30 min after receiving rescue analgesia in both groups (Ppaired < 0.001 for both groups). Notably, the degree of pain relief was significantly higher in the TAPB group than in the sufentanil group (median [interquartile range], -3 [-4, -2] vs. -2 [-2, -1], median difference = -1; 95% confidence interval, -2 to -1; P < 0.001). Moreover, patients in the TAPB group experienced less pain than those in the sufentanil group during the following 24 h. When evaluated, PaO2 increased significantly after rescue analgesia in the TAPB group (Ppaired < 0.001); however, there were no significant intragroup differences in the sufentanil group (Ppaired = 0.129). Patients receiving TAPB experienced better quality of sleep than those receiving sufentanil (P = 0.008), while no statistical difference in gastrointestinal function were observed between the two groups. Conclusion: Rescue analgesia with TAPB on the first postoperative day improved pain, oxygenation, and sleep quality in patients undergoing abdominal surgery; however, its effect on gastrointestinal function requires further research.

    Keywords: rescue analgesia, Transversus abdominis plane block, opioid, Abdominal surgery, Postoperative pain, Oxygenation. Word Count: 3633 Table: 4 Figure: 3

    Received: 25 Jun 2024; Accepted: 27 Sep 2024.

    Copyright: © 2024 He, Wang, Qin, Ye, Wang, Zhang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ye Zhang, Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
    Yun Wu, Department of Anesthesiology and Perioperative Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China

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