Đánh giá hiệu quả giảm đau sau phẫu thuật cắt dạ dày nội soi của gây tê mặt phẳng cơ ngang bụng dưới hướng dẫn siêu âm

Abstract

This study aimed to evaluate the analgesic efficacy, cardiovascular and respiratory effects, and adverse events of bilateral ultrasound-guided transversus abdominis plane (TAP) block using 0.25% levobupivacaine after laparoscopic gastrectomy. A descriptive study was conducted on 60 patients aged ≥ 18 years old, ASA physical status I–III, who underwent laparoscopic gastrectomy at Nghe An Oncology Hospital from September 2024 to October 2025. Outcome measures included pain intensity assessed by the VAS score, total morphine consumption within the first 24 hours, changes in heart rate, blood pressure, respiratory parameters, and adverse events. Mean VAS pain scores during the first postoperative day remained at a moderate level (3–4 at rest and 4–5 during movement) and gradually decreased over time. The mean total morphine dose within 24 hours was 19.75 ± 7.23mg, with a mean rescue morphine dose of 3.23 ± 0.83mg. Cardiovascular and respiratory parameters remained stable within normal ranges. The incidence of nausea and/or vomiting was 13.33%, and mild respiratory depression occurred in one patient (1.67%). No complications related to the block technique or local anesthetic toxicity was observed. Based on aforementioned data, we concluded that ultrasound-guided TAP block is an effective and safe analgesic method for patients undergoing laparoscopic gastrectomy when incorporated into a multimodal analgesia strategy.