Artikel
Verbesserte intraoperative Analgesie bei periazebulärer Osteotomie mittels Transversus abdominis Plane Block
Improved intraoperative analgesia in periacebular osteotomy using transversus abdominis plane block
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Veröffentlicht: | 25. Oktober 2022 |
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Gliederung
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Objectives: Intraoperative analgesia in patients undergoing periacetabular osteotomy (PAO) can be challenging due to the extensive approach and osteotomies associated with relevant pain. The aim of this study was to assess the effect of the transversus abdominis plane block (TAPb) on intraoperative opioid consumption and circulation parameters in PAO patients.
Methods: A two-group randomized-controlled trial was conducted in 42 consecutive patients with symptomatic developmental dysplasia of the hip (DDH) undergoing PAO. Patients of the study group received an ultrasound guided TAPb with 20 ml of 0.75% ropivacaine after general anesthesia induction and prior to surgery. Patients of the control group did not receive a TAPb.
General anesthesia was conducted according to a defined study protocol. The primary endpoint of the study was the intraoperative opioid consumption measured in morphine equivalent dose (MED). Secondary endpoints were the assessment of intraoperative blood pressure, heart rate, need for hypo- or hypertension treatment and length of hospital stay (LOHS). 41 patients (n=21 TAPb group, n=20 control group) completed the study, per protocol. 33 were women (88.5%) and 8 men (19.5%). The mean age at the time of surgery was 28 years (18 to 43, SD ± 7.4). All operations were performed by a single, high-volume surgeon and all TAPb were performed by a single, experienced senior anaesthesiologist.
Results and conclusion: The intraoperative opioid consumption in the TAPb group was significantly lower compared to the control group (931 vs. 1186 MED/kg of body weight; p = 0.016). There were no other significant differences in secondary outcome parameters. No perioperative complication occurred in either group.
Ultrasound guided TAPb significantly reduces the intraoperative opioid consumption in patients undergoing PAO.