Prospective comparison of the intraoperative and postoperative efficiency of rectus sheath block and transversus abdominis plane block

In our study, we aimed to compare the intraoperative and postoperative analgesic efficacy of transversus abdominis plane block (TAPB) and rectus sheath block (RSB) in a prospective and randomized controlled manner in patients undergoing subumbilical and supraumbilical median incisions in general surgery cases. The study was conducted in 80 patients aged between 18-75 years, with the American Society of Anesthesiologists (ASA) classification 1-3, who would undergo subumbilical and supraumbilical median incision after ethics committee approval and written consent from the patients. The demographic data of the patients were recorded and after routine monitoring and general anesthesia induction, they were divided into two groups as group TAPB and group RSB. Hemodynamic data of all patients were recorded pre-induction, post-induction 1. minute and intraoperative 30-minute periods. Patient-controlled analgesia (PCA) prepared with morphine was administered to all patients. Patients intraoperative hemodynamic data and administered opioid dose, postoperative visual analogue scales (VAS) at rest and coughing, time to first PCA dose, postoperative opioid consumption, need for rescue analgesics, duration time until first mobilization, opioid side effects, patient and surgeon satisfaction were evaluated. Intraoperative hemodinamical data, opioid drug administered and postoperative pain scores were smiliar in two groups. Post-operative morfin administration at 2. hour was higher and statisticly significant (p=0,041) in TAPB group. There was no statisticly significant data on follow ups between groups. When other studies are considered, Post-operative pain scores and v first dose of PCA administration at rest and during coughing were similar and low between two groups. Additional analgesia requirement was similar in both groups (p=0,633). It was found that the time to first mobilisation was similar in both TAPB and RSB groups (p=0,798) and opioid side effects were similar (p=0,239). Surgeon satisfaction were similar in both groups. As a result it was found that TAPB and RSB has similar efficiency on patients who underwent surgery with subumbilical and supraumblicial median incision. Keywords: Transversus abdominis plane block, rectus sheath block, pain management, median laparotomy.