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The effect of ultrasound-guided transversus abdominis plane block on pulmonary function in patients undergoing laparoscopic cholecystectomy: a prospective randomized study

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Abstract

Background

Transversus abdominis plane block (TAPB) is commonly used for postoperative pain control after laparoscopic cholecystectomy. However, few studies have analyzed its effect on pulmonary function. The goal of this study was to elucidate the effect of ultrasound-guided bilateral TAPB on pulmonary function preservation and analgesia after laparoscopic cholecystectomy.

Methods

We enrolled 58 patients who underwent laparoscopic cholecystectomy. Among them, 53 were randomized to group T (n = 27) and group C (n = 26). Group T and group C received ultrasound-guided bilateral TAPB with 40 ml of 0.375% ropivacaine and 40 ml of 0.9% normal saline, respectively. Visual analog scale (VAS) scores, patient-controlled analgesia (PCA) consumption, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow rate (PEF), and modified Borg scale scores were measured until 24 h post-surgery.

Results

The VAS scores were significantly lower in group T than in group C at 1 and 8 h after the surgery. PCA consumption was significantly lower in group T than in group C at all postoperative time points. FEV1, PEF, and FEV1/FVC were more preserved in group T than in group C at 1 h. Group T had significantly lower modified Borg scale scores than did group C at 1 and 8 h.

Conclusion

Ultrasound-guided TAPB is effective in pulmonary function preservation and pain control after laparoscopic cholecystectomy. Therefore, it could be a great option for multimodal analgesia, preservation of pulmonary function, prevention of pulmonary complications including atelectasis, and promotion of postoperative recovery after laparoscopic cholecystectomy.

Clinical registration

This study was enrolled in the Clinical Research Information Service (Clinical Research Information Service, KCT0004435, Hwa Yong Shin, 2019-08-19).

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Acknowledgements

We would like to thank Editage (www.editage.co.kr) for English language editing.

Funding

Support was solely provided by institutional and/or departmental sources.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea

    Seung Young Lee, Choon Gun Ryu, Young Hyun Koo, Hana Cho, Haesun Jung, Yong Hee Park, Hyun Kang & Hwa Yong Shin

  2. Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea

    Seung Eun Lee

  3. Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea

    Hwa Yong Shin

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  1. Seung Young Lee
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  2. Choon Gun Ryu
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Correspondence to Hwa Yong Shin.

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Seung Young Lee, Choon Gun Ryu, Young Hyun Koo, Hana Cho, Haesun Jung, Yong Hee Park, Hyun Kang, Seung Eun Lee, and Hwa Yong Shin have no conflicts of interest or financial ties to disclose.

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Lee, S.Y., Ryu, C.G., Koo, Y.H. et al. The effect of ultrasound-guided transversus abdominis plane block on pulmonary function in patients undergoing laparoscopic cholecystectomy: a prospective randomized study. Surg Endosc 36, 7334–7342 (2022). https://doi.org/10.1007/s00464-022-09131-y

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