The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair

Карталов, Андријан; Јankulovski, Nikola; Кузмановска, Билјана; Zdravkovska, Milka; Shosholcheva, Mirjana; Tolevska, Marija; Naumovski, Filip; Srceva, Marija Jovanovski; Petrusheva, Aleksandra Panovska; Selmani, R; Sivevski, Atanas

doi:10.2478/prilozi-2018-0014

Cited by 12 publications

(15 citation statements)

References 22 publications

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“…The analgesic efficacy of RSB in the case of umbilical hernia had been studied by Kartalov et al [15] . They evaluated the analgesic effects of the bilateral ultrasound guided RSB as supplement of general anesthesia on 60 patients undergoing elective umbilical hernia repair.…”

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of erector spinae plane block versus rectus sheath block in adults undergoing open para-umbilical hernia repair

Hussein

Sadek

Abu-Elyazed

et al. 2022

ijhs

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Background: Rectus sheath block (RSB) is a popular technique for post-operative analgesia for patients undergoing abdominal surgeries with midline incisions. Ultrasound-guided erector spinae plane block (ESPB) is an interfacial plane block for the treatment of post-operative neuropathic pain. The aim of this study was to compare the analgesic efficacy of ESPB versus RSB in adult patients undergoing open para-umbilical hernia repair. Methods: This prospective randomized double-blinded study was carried out on seventy-four adult patients with ASA physical status I-II undergoing open paraumbilical hernia repair. Patients were divided into two equal groups: group I (ESPB): patients received bilateral ultrasound-guided ESPB using bupivacaine 0.25% (20 ml) on each side and group II (RSB): patients received bilateral ultrasound-guided RSB using bupivacaine 0.25% (20 ml) on each side. The following measurements was recorded: VAS score, intraoperative fentanyl consumption, the time to the first postoperative rescue analgesia administration, total dose of postoperative rescue analgesia (morphine) consumption, heart rate and mean arterial blood pressure.

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Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of erector spinae plane block versus rectus sheath block in adults undergoing open para-umbilical hernia repair

Hussein

Sadek

Abu-Elyazed

et al. 2022

ijhs

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“…The introduction of local anaesthetic agents with a prolonged duration of action has led a revival of interest in this facet of local anaesthesia. 12 Previous authors have performed RSB for postoperative analgesia in various surgeries like major abdominal surgeries, [13][14][15] gynecological surgeries, 16,17 laproscopic surgeries 18 using different local anaesthetics (bupivacaine, 19 ropivacaine, 18 levobupivacaine, 13 ) and found promising results.…”

Section: Discussionmentioning

confidence: 99%

Comparision of analgesic efficacy of ropivacaine and bupivacaine in rectus sheath block for midline abdominal surgeries

Kuldeep¹,

Gehlot²,

Sharma³

et al. 2020

IJCA

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Background: In the modern setting the rectus sheath block (RSB) has been found effective in decreasing opioid requirement after both diagnostic and interventional laparoscopy and laparotomy. Efficacy of rectus sheath block (RSB) using ropivacaine versus bupivacaine for acute postoperative pain relief is not much investigated. Material and Methods: 90 patients undergoing elective midline abdominal surgeries under general anaesthesia were randomly divided into three groups of 30 patients each, destined to receive bilateral rectus sheath block using 15 ml on each side (total 30 ml) of 0.25% ropivacaine in Group R, 0.25% bupivacaine in Group B or normal saline in Group C. Three groups were compared regarding time to first rescue analgesic from time of RSB (duration of analgesia), total rescue analgesic (tramadol) consumption in first 10 hours, visual analogue score (VAS), satisfaction score and adverse effects. Result: Mean duration of analgesia was significantly longer in group R (5.78±0.93h) than group B (3.63±0.90 h) and group C (2.37±0.44 h), p<0.001 (group R > group B > group C). This trend was observed in both hernia repair and laparotomy. Rescue analgesic consumption in terms of number of doses was significantly less in Group R (30) than in Group B (38) than in Group C (59), p<0.05. Mean VAS was significantly less and patient satisfaction was significantly better in Group R than in Group B than in Group C, (p<0.001). Conclusion: Bilateral single shot rectus sheath block (RSB) using isobaric ropivacaine (0.25%) or bupivacaine (0.25%) is a safe and effective method of providing postoperative analgesia to patients undergoing midline abdominal surgeries. The lower cardio toxicity profile with the excellent prolonged postoperative analgesia makes ropivacaine an excellent choice for the RSB as compared to bupivacaine.

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“…• Rectus Sheath Block: It is an anterior abdominal block that reduces postoperative pain associated with midline incisions around the umbilicus and laparoscopic surgery. Ultrasound-guided rectus sheath block will block the ventral rami of 7th-12th thoracolumbar nerve by injecting the LA into the space between the rectus muscle and posterior sheath [59]. Potential complications are related to LA toxicity and needle injury, namely injury to epigastric vessels and wound infections.…”

Section: Blocks Of Anterior Abdominal Wallmentioning

confidence: 99%

“…Potential complications are related to LA toxicity and needle injury, namely injury to epigastric vessels and wound infections. These are rare with ultrasound-guided blocks [59]. A study showed that rectus sheath block provided analgesia equivalent to epidural analgesia in colorectal surgery with advantage of lesser incidence of hypotension [60].…”

Section: Blocks Of Anterior Abdominal Wallmentioning

confidence: 99%

Acute Post-Operative Pain Management

Khatib¹,

Razvi²,

Shaikh³

et al. 2023

Updates in Anesthesia - The Operating Room and Beyond

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Despite major advances in the field of anesthesia and medicine, postoperative pain continues to be undermanaged in a significant proportion of patients. The consequences of undermanaged pain are deleterious for both patients and the healthcare system. This review aims to give the readers a practical and updated approach to acute postoperative pain management. This chapter deals with the definition of pain, the physiology and pathophysiology of pain, and various approaches to the management of acute pain. A review of the literature was done to understand the methods of pain management with a major focus on the literature of the last decade (2010–2022). A literature search was done on PubMed and Google Scholar using keywords “acute postoperative pain” and “pain physiology.” The research papers on the basics of pain physiology, the prevalence of acute post-operative pain and methods of acute postoperative pain management were reviewed. A brief practical approach for acute postoperative pain using pharmacological and non-pharmacological approaches and a brief discussion have been done on the approach for special group of patients. The management of acute postoperative pain can be done using various pharmacological and non-pharmacological methods. The approach for each patient has to be tailored depending on the individual patient’s needs.

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The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair

Abstract: The ultrasound guided rectus sheath block used for umbilical hernia repair could reduce postoperative pain scores and the amount of morphine consumption in 24 hours postoperative period.

Cited by 12 publications

References 22 publications

Analgesic efficacy of erector spinae plane block versus rectus sheath block in adults undergoing open para-umbilical hernia repair

Analgesic efficacy of erector spinae plane block versus rectus sheath block in adults undergoing open para-umbilical hernia repair

Comparision of analgesic efficacy of ropivacaine and bupivacaine in rectus sheath block for midline abdominal surgeries

Acute Post-Operative Pain Management

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