Objective To explore the effect of esketamine combined with transversus abdominis plane block （TAP） on intraoperative analgesia and postoperative quality of recovery among patients undergoing laparoscopic cholecystectomy （LC）. Methods A total of 96 patients at 40-75 years of age undergoing LC were randomly divided into three groups： esketamine group （group S, n=33）, TAP group （group T, n=31）, and esketamine + TAP group （group TS, n=32）. Patients in the group S and the group TS received 0.125 mg/kg esketamine immediately following the induction of anesthesia. Patients in the group T and the group TS received TAP block after induction of anesthesia. Observations included QoR-40 at postoperative 24 h, intraoperative opioid and propofol consumption, NRS score, and the incidence of post-operative nausea and vomiting （PONV） at postoperative 2 d. Results Compared with group S and group T, global QoR-40 scores and the dimensional scores of emotional state, pain, and physical independence were significantly higher in the group TS at postoperative 24 h, and the NRS score of the group TS was significantly lower than those in the group S and the group T at postoperative 4, 8, and 24 h （P<0.05）. The Ramsay score of the group TS was significantly lower than those in the group S and the group T at postoperative 0.5, 4, and 8 h （P<0.05）. Conclusion Small doses of ketamine in addition to TAP can improve the quality of recovery and reduce postoperative pain.
HU Rui
,
FENG Xiumei
,
LIU Jing
. Effect of esketamine combined with transversus abdominis plane block on recovery quality of laparoscopic cholecystectomy surgery patients[J]. Surgical Research and New Technique, 2022
, 11(3)
: 174
-178
.
DOI: 10.3969/j.issn.2095-378X.2022.03.008
[1] 赵嫣红,张晓庆.超声引导下腹横肌平面阻滞用于腹部手术的研究进展[J].外科研究与新技术,2017,6(3):193-197.
[2] Moeschler SM, Pollard EM, Pingree MJ, et al.Ultrasound-guided transversus abdominis plane block vs. trigger point injections for chronic abdominal wall pain: a randomized clinical trial[J]. Pain, 2021,162(6): 1800-1805.
[3] Desai N, Boghdadly K, Albrecht E, et al.Transversus abdominis plane block for abdominal surgery-a systematic review, meta-analysis and trial sequential analysis[J].Anaesthesia, 2021, 76(3): 101-117.
[4] Doo AR, Kang S, Kim YS, et al.The effect of the type of anesthesia on the quality of postoperative recovery after orthopedic forearm surgery[J]. Korean J Anesthesiol, 2020, 73(1):58-66.
[5] Koshyari HS, Asthana V, Agrawal S, et al.Evaluation of lignocaine infusion on recovery profile, quality of recovery, and postoperative analgesia in patients undergoing total abdominal hysterectomy[J]. J Anaesthesiol Clin Pharmacol, 2019, 35(4): 528-532.
[6] Gornall B, Myles P, Smith C, et al.Measurement of quality of recovery using the QoR-40: A quantitative systematic review[J]. B J Anaesth, 2016,66(4):369-375.
[7] Wu CL, Berenholtz SM, Pronovost PJ, et al.Systematic review and analysis of postdischarge symptoms after outpatient surgery[J]. Anesthesiology, 2002,96(4):994-1003.
[8] Joe YE, Kang CM, Lee HM, et al.Quality of recovery of patients who underwent curative pancreatectomy: Comparison of total intravenous anesthesia versus inhalation anesthesia using the QOR-40 Questionnaire[J]. World J Surg, 2021,45(8):2581-2590.
[9] Chen Y, Wang J, Liu S, et al.Development and validation of the Chinese version of the Quality of Recovery-40 Questionnaire[J]. Ther Clin Risk Manag, 2020,16:1165-1173.
[10] 佘锐璇. 硫酸镁复合罗哌卡因行TAP阻滞对腹腔镜子宫切除术术后镇痛效果的影响[J].外科研究与新技术,2021,10(3):200-202.
[11] Ravichandran NT, Sistla SC, Kundra P, et al.Laparoscopic-assisted tranversus abdominis plane (TAP) block versus ultrasonography-guided transversus abdominis plane block in postlaparoscopic cholecystectomy pain relief: Randomized controlled trial[J]. Surg Laparosc Endosc Percutan Tech, 2017, 27(4): 228-232.
[12] Oksar M, Koyuncu O, Turhanoglu S, et al.Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy[J]. J Clin Anesth,2016, 34(1): 72-78.
[13] 张斌,董楠,杨君君,等.小剂量丙泊酚联合氯胺酮镇静对骨科小儿安全[J].外科研究与新技术,2014,3(2):96-98.
[14] Nielsen RV, Fomsgaard JS, Nikolajsen L, et al.Intraoperative S-ketamine for the reduction of opioid consumption and pain one year after spine surgery: A randomized clinical trial of opioid-dependent patients[J]. Eur J Pain, 2019, 23(3): 455-460.
[15] Moro ET, Feitosa IM, Oliveira RG, et al.Ketamine does not enhance the quality of recovery following laparoscopic cholecystectomy: a randomized controlled trial.[J].Acta Anaesthesiol Scand, 2017, 61(7): 740-748.
[16] Correia-Melo FS, Leal GC, Vieira F, et al.Efficacy and safety of adjunctive therapy using esketamine or racemic ketamine for adult treatment-resistant depression: A randomized, double-blind, non-inferiority study.[J]. J Affect Disord, 2020, 264(4): 527-534.
[17] Falk E, Schlieper D, Caster P, et al.A rapid positive influence of S-ketamine on the anxiety of patients in palliative care: a retrospective pilot study.[J]. BMC Palliat Care, 2020, 19(1):1.
