Transversus Abdominis Plane Block Associated With Locoregional Anesthesia With a Laparotenser for Gynecologic Surgery in an Awake State

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• 作者：Antonio Pellegrino ; MD^a ; Gianluca Raffaello Damiani ; MD^a ; ^c ; ^{damiani14@alice.it} ; Daniele Speciale ; MD^b ; Roberto Speciale ; MD^b ; Riccardo Massei ; MD^b ; Stefano Landi ; MD^b ; ^c ; Mario Villa ; MD^b
• 关键词：Laparoscopy ; Laparotenser ; Locoregional anesthesia ; Tap block ; Ultrasound-guided
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2013
• 出版时间：March-April, 2013
• 年：2013
• 卷：20
• 期：2
• 页码：230-233
• 全文大小：505 K

文摘

The laparotenser instrument is used to perform isobaric laparoscopy to avoid adverse effects in the pneumoperitoneum. To decrease hospitalization time and increase the rate of same-day discharge, we investigated the safety of isobaric laparoscopy using the Laparotenser, a new subcutaneous abdominal wall-lifting system, with transversus abdominis plane (TAP) block combined with locoregional anesthesia (subarachnoid, peridural, spino-peridural) for patients undergoing minor and major gynecologic surgeries. With this combination of anesthetics, TAP block enabled us to anesthetize the supraumbilical region while the pelvic region was covered by locoregional anesthesia. We describe our experience with TAP blockade associated with locoregional anesthesia during gasless laparoscopy. We performed ultrasound-guided TAP block with ropivacaine 0.25 % 20 mL to cover the supraumbilical region in association with locoregional anesthesia (lumbar subarachnoid-peridural-spinoperidural) and bupivacaine 0.5 % (10 mg/3 mL) to cover the lower pelvic region. Successful outcome was reported in?81.3 % (13/16) of the patients.