Recommended

A Case Report: Pseudomonas Luteola Presenting ...

General Malaise In An Elderly Male Patient

Influence Of Assistive Technology For The Maint...

The Comparison Of Resilience And Spirituality I...

Is Hashimoto’s Thyroiditis A Risk Factor For ...

0 votes
Intravenous Patient-controlled Fentanyl With And Without Transversus Abdominis Plane Block In Cirrhotic Patients Post Liver Resection
Author: Serag Eldin M, Mahmoud F, El Hassan R, Abdel Raouf M, Afifi Mh, Yassen K, Morad W
Publisher: Derivative Works
11 pages
One time payment: €0.00
Required subscription: Free
Type of publication: Article
ISBN/ISSN: 1124-8882
DOI: 10.2147/60966
Follow this publisher

Share this publication:

Description:

Background: Coagulation changes can complicate liver resection, particularly in patients with cirrhosis. The aim of this prospective hospital-based comparative study was to compare the postoperative analgesic efficacy of intravenous fentanyl patient-controlled analgesia (IVPCA) with and without transversus abdominis plane (TAP) block. Methods: Fifty patients with Child’s A cirrhosis undergoing liver resection were randomly divided into two groups for postoperative analgesia, ie, an IVPCA group receiving a 10 µg/mL fentanyl bolus of 15 µg with a 10-minute lockout and a maximum hourly dose of 90 µg, and an IVPCA + TAP group that additionally received TAP block (15 mL of 0.375% bupivacaine) on both sides via a posterior approach with ultrasound guidance before skin incision. Postoperatively, bolus injections of bupivacaine 0.375% were given every 8 hours through a TAP catheter inserted by the surgeon in the open space during closure of the inverted L-shaped right subcostal with midline extension (subcostal approach) guided by the visual analog scale score (,3, 5 mL; 3 to ,6, 10 mL; 6–10, 15–20 mL) according to weight (maximum 2 mg/kg). The top-up dosage of local anesthetic could be omitted if the patient was not in pain. Coagulation was monitored using standard coagulation tests. Results: Age, weight, and sex were comparable between the groups (P.0.05). The visual analog scale score was significantly lower at 12, 18, 24, 48, and 72 hours (P,0.01) in IVPCA + TAP group. The Ramsay sedation score was lower only after 72 hours in the IVPCA + TAP group when compared with the IVPCA group (1.57±0.74 versus 2.2±0.41, respectively, P,0.01). Heart rate, systolic blood pressure, and fentanyl consumption were lower in the IVPCA + TAP group at 24, 48, and 72 hours (P,0.05). Intensive care unit stays were significantly shorter with TAP (2.61±0.74 days versus 4.35±0.79 days, P,0.01). Prothrombin time and International Normalized Ratio indicated temporary hypocoagulability in both groups.

About the publisher:

We are a publishing house devoted to reuse CC-BY licensed published materials.

 

Using CC-BY licenses:

YOU ARE FREE TO:

  • Adapt — remix, transform, and build upon the material
  • for any purpose, even commercially.
  • The licensor cannot revoke these freedoms as long as you follow the license terms.

UNDER THE FOLLOWING TERMS:

  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others
    from doing anything the license permits.

NOTICES:

  • You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
  • No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.

Select a payment method