ASSESSMENT OF RECTUS SHEATH BLOCK EFFECTIVENESS AFTER MAJOR ABDOMINAL SURGERY

Objective. Assessment of rectus sheatus block effectiveness after major abdominal surgery. Material and methods. 120 patients after gastrectomy and pancreatoduodenal resections were examined. In the postoperative period, patients of the 1st group (n = 40) were given epidural infusion of 0.2% solution of ropivacaine 5 ml / h, patients of the 2nd (n = 40) and 3rd groups (n = 40) in the rectus sheatus introduced 10 ml of a 0.375% solution of ropivacaine with an interval of 8 hours and a constant infusion of 0.2% solution of ropivacaine 5 ml/h were bolus administered respectively. The intensity of the pain syndrome was assessed at rest and during mobilization, and frequency the need for additional of narcotics, suppuration, and patient satisfaction. Results. The intensity of the pain syndrome for 48 hours had no significant difference. The need for drugs in the 2nd group was less than in the 1st and 3rd groups. The incidence of wound suppuration between the groups did not differ significantly. The patient’s satisfaction with analgesia was 3.8 ± 0.44 points in the 2nd group, 2.7 ± 0.88 points and 2.6 ± 0.73 points in the 1st and 2nd groups (p <0, 05). Conclusion. The bolus injection of a local anesthetic solution into the of rectus sheatus after extensive abdominal operations provides postoperative analgesia comparable to epidural analgesia, does not require special skills from an anesthesiologist, is safe and effective.

postoperative pain, bilateral rectus sheath block epidural analgesia, ropivacaine