The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair

Kartalov, Andrijan and Jankulovski, Nikola and Kuzmanovska, Biljana and Zdravkovska, Milka and Shosholcheva, Mirjana and Tolevska, Marija and Naumovski, Filip and Srceva, Marija and Panovska Petrusheva, Aleksandra and Selmani, Rexhep and Sivevski, Atanas (2018) The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair. Contributions, Sec. Biol. Med. Sci., 38 (3). pp. 135-142. ISSN 1857-9345

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Abstract

Background: Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar
nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair.
Methods: After the hospital ethics committee approval, 60 (ASA I–II) adult patients scheduled for umbilical
hernia repair were included in this study. The group I (n=30) patents received only general anesthesia. In
the group II (n = 30) patents after induction of general anesthesia received a bilateral ultrasound guided
rectus sheath block with 40 ml of 0.25% bupivacaine. In this study we assessed demographic and clinical
characteristics, pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after operation and total analge¬sic
consumption of morphine dose over 24-hours.
Results: There were statistically significant differences in VAS scores between the groups I and II at all
postoperative time points - 2hr, 4 hr, 6 hr, 12 hr and 24 hr. (P < 0.00001). The cumulative 24 hours morphine
consumption after the operation was significantly lower in the group II (mean = 3.73 ± 1. 41) than
the group I (mean = 8.76 ± 2.41). This difference was statistically significant (p = 0.00076).
Conclusion: The ultrasound guided rectus sheath block used for umbilical hernia repair could reduce
postoperative pain scores and the amount of morphine consumption in 24 hours postoperative period.
Keywords: Umbilical hernia repair, Ultrasound guided rectus sheath block, Bupivacaine

Item Type:	Article
Subjects:	Medical and Health Sciences > Basic medicine Medical and Health Sciences > Clinical medicine Medical and Health Sciences > Health sciences
Divisions:	Faculty of Medical Science
Depositing User:	Milka Zdravkovska
Date Deposited:	01 Feb 2019 10:06
Last Modified:	01 Feb 2019 10:06
URI:	https://eprints.ugd.edu.mk/id/eprint/21236

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