To observe the effect of ultrasound guided TAPB combined with general anesthesia on tissue perfusion and postoperative pain in patients undergoing open gastrointestinal operation.

This was a single institute retrospective cohort study. From February to December 2019, sixty patients with ASA I or II undergoing emergency open gastroenterotomy in Sun Yat-Sen Memorial Hospital of Sun Yat-sen University were eligible to be analyzed and divided into control group and TAPB group. There were 39 males and 21 females, aged 20 ~ 65 years, with an average age of 48.1 ± 4.1 years. Propensity score matching method was used to balance the baseline characteristics. Two groups were matched in a 1∶1 ratio. There were 30 cases per group after matched. The TAPB group received bilateral TAPB on the basis of general anesthesia, and the control group received general anesthesia with tracheal intubation. The changes of MAP and HR were observed after entering the room, cutting skin, separating muscle layer and separating parietal peritoneum. ScvO₂ and ABL at the beginning of operation (T0), 1 h after the beginning of operation (T1), 2 h after the beginning of operation (T2), and the end of operation (T3) were also observed; The dosage of sevoflurane, remifentanil, norepinephrine or atropine, and VAS scores after operation between the two groups were compared. The incidence of TAPB related complications was recorded and analyzed.

The MAP and HR in the TAPB group were more stable than that in the control group(P<0.05); The ScvO₂ in the TAPB group at T1 [(75.9±4.5)% vs. (73.1±3.2)%], T2 [(75.4±4.6)% vs. (72.8±3.3)%] and T3 [(74.7±4.4)% vs. (71.5±3.5)%] was higher and the ABL at T3 [(0.8±0.4) mmoL/L vs. (1.2±0.4) mmoL/L] was significantly lower than that in the control group (P<0.05); Compared with the control group, the amount of sevoflurane [(52.4±7.9) mL vs. (61.6±10.4) mL], remifentanil [(1.7±0.4) mg vs. (2.6±0.5) mg], norepinephrine [(0.8±0.3) mg vs. (1.4±0.5) mg] or atropine [(0.2±0.1) mg vs. (0.4±0.2) mg] and tramadol [(127.4±32.6) mg vs. (252.3±62.5) mg] in the TAPB group was less, and the VAS scores of postoperation 2 h [(2.4±0.6) vs. (3.8±1.0)], 24 h [(2.0±0.5) vs. (2.5±0.7)] were lower (P<0.05). No TAPB related complications occurred in all the patients.

TAPB combined with general anesthesia can ensure a good tissue perfusion during the open gastrointestinal operation, maintain the hemodynamic stability, significantly reduce the amount of anesthetics and vasoactive drugs during the operation, and reduce the postoperative pain of the patients, which is worth popularizing.