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KMID : 1147920180010010023
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Medical Biological Science and Engineering
2018 Volume.1 No. 1 p.23 ~ p.30
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Comparison of analgesic efficacy of oblique subcostal and lateral transversus abdominis plane block after laparoscopic cholecystectomy
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So Keum-Young
Jee In-Gook
Jung Ki-Tae
Kim Sang-Hun
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Abstract
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This prospective, double-blinded, randomized, controlled study was undertaken to compare the additional postoperative analgesic effects of oblique subcostal and lateral transversus abdominis plane blocks using visual analog scale (VAS) scores and algometry determined pressure pain thresholds (PPTs), and to investigate the correlation between VAS scores and PPTs in patients on patient-controlled analgesia (PCA) after laparoscopic cholecystectomy. Sixty patients aged 20 to 65 years, ASA physical status I or II, were randomly allocated to one of three groups: a group not administered a TAP block (TAPC group, n=20), a group that received an oblique subcostal TAP block (TAPS group, n=20), and a group that received a lateral TAP block (TAPL group, n=20). Bilateral TAP blocks were performed after skin closure. All patients subsequently received fentanyl (20 μg/kg) PCA. At 8 hours postoperatively, VAS scores during coughing was negatively correlated with PPTs on right skin incision site (r=-0.418, p=0.001). We conclude oblique subcostal and lateral TAP blocks have no additional postoperative analgesic effect in patients on PCA after laparoscopic cholecystectomy, and suggest that algometer determined PPTs offer a potential objective alternative to VAS scores for assessing postoperative pain.
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KEYWORD
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Cholecystectomy, laparoscopic, Pain, postoperative, Pressure pain threshold, Transversus abdominis plane block, Visual analog scale
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