Efficacy of abdominal peripheral nerve block and caudal block during robot-assisted laparoscopic surgery: a retrospective clinical study
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We retrospectively analyzed the efficacy of abdominal peripheral nerve block (PNB) and caudal block (CB) in patients undergoing robot-assisted laparoscopic radical prostatectomy (RARP).
Patients who underwent elective RARP at our hospital (Jan. 2015–Sept. 2016) were enrolled. We reviewed the 188 patients’ anesthesia charts and medical records and divided the patients into three groups based on the anesthesia used in their cases: 76 patients in the total intravenous anesthesia (TIVA) group, 51 patients in the TIVA + abdominal PNB group (TI-PB group), and 61 patients in the TIVA + abdominal PNB + CB (TI-PB-CB group). We compared the groups’ amounts of anesthetic drug usage, anesthesia times, and the presence/absence of additional opioid administration in the recovery room.
The perioperative opioid use during anesthesia was significantly greater in the TIVA group than in the TI-PB-CB group. The total amount of muscle relaxant was significantly higher (p < 0.001) in the TIVA group than the TI-PB-CB group: 60.0 (50.0–70.0) mg vs. 50.0 (40.0–60.0) mg. Although there were no significant differences in the operation time, the frequency of the use of additional opioid administration was significantly higher (p < 0.01) in the TIVA group than the TI-PB group: 23.7% vs. 2.0%, respectively.
Although there was no influence on the anesthesia time, the muscle relaxant dose and the perioperative amount of opioid use were significantly less in the combined PNB + CB group. Our analyses suggest that not only PNB but also CB was useful for perioperative management in RARP.
Clinical trial registration
KeywordsPeripheral nerve block Caudal block Muscle relaxant Robotic surgery
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest.
- 4.Schleich CL. Schmerzlose Operationen. 4th ed. Berlin: Springer; 1899, pp. 240–8.Google Scholar
- 5.Tsuchiya M, Kyoh Y, Mizutani K, Yamashita J, Hamada T. Ultrasound-guided single shot caudal block anesthesia reduces postoperative urinary catheter-induced discomfort. Minerva Anestesiol. 2013;79:1381–8.Google Scholar
- 6.Agarwal A, Pandey R, Dhiraaj S, Singh PK, Raza M, Pandey CK, Gupta D, Choudhury A, Singh U. The effect of epidural bupivacaine on induction and maintenance doses of propofol (evaluated by bispectral index) and maintenance doses of fentanyl and vecuronium. Anesth Analg. 2004;99:1684–8.CrossRefGoogle Scholar
- 8.Kokulu S, Bakı ED, Kaçar E, Bal A, Şenay H, Üstün KD, Yılmaz S, Ela Y, Sıvacı RG. Effect of transversus abdominis plane block on cost of laparoscopic cholecystectomy anesthesia. Med Sci Monit. 2014;20:2783–7.Google Scholar
- 9.Calì Cassi L, Biffoli F, Francesconi D, Petrella G, Buonomo O. Anesthesia and analgesia in breast surgery: the benefits of peripheral nerve block. Eur Rev Med Pharmacol Sci. 2017;21:1341–5.Google Scholar
- 10.Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. Preventive analgesia for postoperative pain control: a broader concept. Local Reg Anesth. 2014;7:17–22.Google Scholar
- 15.Kaya Z, Süren M, Arici S, Karaman S, Tapar H, Erdemir F. Prospective, randomized, double-blinded comparison of the effects of caudally administered levobupivacaine 0.25% and bupivacaine 0.25% on pain and motor block in children undergoing circumcision surgery. Eur Rev Med Pharmacol Sci. 2012;16:2014–20.Google Scholar
- 16.Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2010.Google Scholar
- 18.Goldstein A, Grimault P, Henique A, Keller M, Fortin A, Darai E. Preventing postoperative pain by local anesthetic instillation after laparoscopic gynecologic surgery: a placebo-controlled comparison of bupivacaine and ropivacaine. Anesth Analg. 2000;91:403–7.Google Scholar
- 19.Yakoshi C, Hashimoto H, Niwa H, Kitayama M, Kudou T, Kudou M, Hirota K. Analgesic efficacy and clinical safety of intraperitoneal instillation combined with rectus sheath block using ropivacaine for pain relief after laparoscopic gynecological surgery. Masui. 2014;63:296–302.Google Scholar