Comparison of application of epidural block and transverse abdominis plane block in elderly patients undergoing laparoscopic radical prostatectomy under ERAS mode
Objective To compare the perioperative analgesic effects and postoperative functional recovery in elderly pa-tients undergoing laparoscopic radical prostatectomy with epidural block and ultrasound-guided transversus abdominis plane block under accelerated rehabilitation surgery(ERAS)mode.Methods A total of 120 patients who underwent elective laparoscopic radical prostatectomy in Cancer Hospital Affiliated to Fudan University from February 2023 to October 2023 were enrolled.Ac-cording to random number table method,they were divided into general anesthesia combined with epidural block group(EA group)and general anesthesia combined with transversus abdominis plane block group(TAP group),60 cases in each group.Visual Analogue Scale(VAS)was used to evaluate and compare the postoperative pain degree of the two groups.The dosage of sufentanil used during the perioperative period,the recovery time of gastrointestinal function(the time of first anal exhaust and defecation,the time of first drinking water and the time of eating semi-liquid food),time to get out of bed for the first time,catheter removal time,length of hospital stay,adverse reactions and incidence of surgical complications were observed and com-pared between the two groups.Results Because 4 patients were excluded from the study,116 ones were finally included in the statistics.There was no significant difference in VAS scores between the two groups at various postoperative time points in both resting and exercising states(P＞0.05).There was no statistically significant difference in the dosage of sufentanil used during the perioperative period between the two groups(P＞0.05).The exhaust time,defecation time,feeding time and ground activity time of the TAP group were significantly shorter than those of the EA group(P＜0.05).There was no significant difference in the catheter removal time and length of hospital stay between the two groups(P＞0.05).There was no significant difference in the incidence of postoperative adverse reactions between the EA group and the TAP group(8.62% vs6.90% ,P＞0.05).There was no significant difference in the incidence of the surgical complications between the EA group and the TAP group(5.17% vs 3.45% ,P＞0.05).Conclusion The transversus abdominis plane block may provide a good analgesic effect equivalent to epi-dural anesthesia for elderly patients undergoing laparoscopic radical prostatectomy.It can promote the recovery of gastrointestinal function in elderly patients,is conducive to the early movement of patients out of bed,and is more in line with the concept of ERAS.
国家科技期刊平台
NSTL
万方数据
维普
