Objective:To investigate the analgesic effect and safety of ultrasound-guided transversus abdominis plane(TAP)block combined with local anesthesia for microwave ablation(MWA)of hepatocellular carcinoma.Methods:Patients with hepatocellular carcinoma who underwent ultrasound-guided microwave ablation after ultrasound-guided TAP block combined with local anesthesia in Jiangsu Cancer Hospital from November 2021 to June 2023 were retrospectively analyzed.According to the ablation site and range of preoperative ipsilateral subcostal margin+Petit triangle dual access TAP block combined with local anesthesia,and ultrasound-guided TAP in-plane injection of 0.375%ropivacaine 20 mL,and patients were evaluated by using numerical rating scale(NRS)to assess the pain level in the intraoperative period,and the postoperative period of 30 min,1 h,3 h,6 h,12 h and 24 h.The pain level of the block was observed.The pain level of the patients was evaluated using the numerical rating scale(NRS)during the operation,30 min,1 h,3 h,6 h,12 h and 24 h after the operation,and the block efficiency,complication occurrence,and the amount of remedial analgesic used during and after the operation were observed.Results:All 13 patients with hepatocellular carcinoma underwent microwave ablation in 1 session,and TAP block combined with local anesthesia was successfully performed.Three(23.1%)patients had mild pain(NRS)without intervention;one(7.7%)patient had moderate pain,and the ablation was completed with intramuscular analgesic drugs.Postoperatively,3(23.1%)patients had mild pain without intervention,all of which resolved spontaneously within 6 h.There were no intraoperative or postoperative complications related to TAP block.All patients were 100.0%satisfied with the effect of TAP block combined with local anesthesia for 24 h after ablation.Conclusion:Ultrasound-guided TAP block combined with local anesthesia is safe and effective in microwave ablation of hepatocellular carcinoma,broadening the application range of microwave ablation of hepatocellular carcinoma.
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