Journal of Internal Medicine Concepts & Practice ›› 2023, Vol. 18 ›› Issue (03): 152-156.doi: 10.16138/j.1673-6087.2023.03.004

• Original article • Previous Articles     Next Articles

Contrast study on efficacy of ultrasound-guided transversus abdominis plane block combined with rectus sheath block in peritoneal dialysis catheterization

WANG Chaojun1*, YU Ling1*, WANG Hengjie1, REN Hong2, SHI Manman1, ZHENG Hong1, MA Yuhua1(), XU Tian2()   

  1. 1. Department of Nephrology, Kunshan Hospital Affiliated to Nanjing University of Chinese Medicine, Kunshan 215300, China
    2. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2022-10-31 Online:2023-06-30 Published:2023-08-07

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Abstract:

Objective To compare the effects of ultrasound-guided transversus abdominis plane block(TAPB) combined with rectus sheath block(RSB), TAPB and local infiltration anesthesia in peritoneal dialysis catheterization，and to explore and promote the ideal anesthesia method for peritoneal dialysis catheterization. Methods A total of 46 patients who underwent peritoneal dialysis catheterization in our hospital from May 2016 to June 2021 were enrolled and randomly divided into three groups according to the random number method: ultrasound-guided TAPB combined with RSB (group A)，ultrasound-guided TAPB (group B) and local infiltration anesthesia group (group C). The mean arterial pressure (MAP), heart rate, visual analogue scale (VAS) score at different time points during the operation [anesthesia (T0), skin incision (T1), separation of rectus abdominis (T2), establishment of subcutaneous tunnel (T3), and skin suture (T4)], overall operation duration, number of additional anesthetics, number of intraoperative and postoperative adverse reactions and postoperative complications were compared and analyzed among three groups. Results There was no statistically significant difference in MAP and heart rate (all P>0.05) in group A and group B, while both MAP and heart rate in group C showed significant difference (P<0.05) during the operation time (T0, T1, T2, T3 and T4). Compared with group A, additional anesthetics during operation in group B and group C was more frequently used (P<0.05). Compared with group A, the VAS scores of group B at T2, and the VAS scores of group C at T1, T2, T3 and T4 were significantly higher (P<0.05). The operation time of group A was significantly shorter than that of group B and group C (P<0.05). The postoperative complications in group A were significantly less than those in group B and group C (P<0.05). Conclusions Compared with ultrasound-guided TAPB and local infiltration anesthesia, the ultrasound-guided TAPB combined with RSB is a relatively ideal anesthesia method for peritoneal dialysis catheterization, which shows the advantages of safe anesthesia, stable hemodynamics, better comfort and fewer postoperative complications.

Key words: Ultrasound-guided, Transversus abdominis plane block combined with rectus sheath block, Transversus abdominis plane block, Local infiltration anesthesia, Peritoneal dialysis catheterization

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