• Users Online: 337
  • Print this page
  • Email this page
ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 2  |  Page : 422-426

Effect of ultra-low-dose naloxone with ultrasound-guided transversus abdominis plane block on postoperative pain relief in patients undergoing laparoscopic cholecystectomy


Anesthesia Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt

Correspondence Address:
MD Ahmed M.M AEl-Garhy
MD of Anesthesia and ICU, Anesthesia Department, Faculty of Medicine, Al Azhar University, Cairo, 12512
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjamf.sjamf_49_19

Get Permissions

Introduction Transversus abdominis plane (TAP) blocks have been described as an effective component of multimodal postoperative analgesia for a wide variety of abdominal procedures such as bowel resection, open/laparoscopic appendectomy, cesarean delivery, hysterectomy, laparoscopic cholecystectomy, open prostatectomy, renal transplant surgery, and abdominoplasty. Various adjuvants have been added to augment the effect and prolong the duration of action of analgesia in TAP block. The mechanism of action of ultra-low-dose naloxone includes selective inhibition of the impulses from excitatory opioid receptors and release of encephalin. Aim This study investigated the effect of ultra-low-dose naloxone on intensity and duration of analgesia of transversus abdominis plane block (TAP block). The primary outcome of the work is to assess the quality of TAB block with addition of ultra-low-dose naloxone in terms of time to first analgesic request (rescue analgesia) and visual analogue score (VAS) score. The secondary outcome is to assess opioid consumption and occurrence of complications (nausea and vomiting). Patients and methods A total of 100 elective laparoscopic cholecystectomy patients were included in our study who were divided randomly into two groups: in the naloxone group (N) (50 patients), bilateral ultrasound-guided subcostal TAP block was done with injection of bupivacaine 0.25% in the plane +100 ng naloxone with total volume of 20 ml in each side, and in the control group (C) (50 patients), bilateral ultrasound-guided subcostal TAP block was done with injection of bupivacaine 0.25% in the plane with total volume 20 ml in each side. Then, the patients were assessed for postoperative pain after full recovery as baseline and then every 4 h for 24 h by VAS. Time to first analgesic request (rescue analgesia), postoperative opioid consumption for the first 24 h, and any adverse effects (nausea and vomiting) were noted. Results We found, a highly significant decrease in VAS scores at 12, 16, 20, and 24 h in naloxone group compared with the control group (P<0.01). There was a nonsignificant difference regarding VAS scores at PACU, 4, and 8 h (P>0.05). Moreover, there was a highly significant increase in time to first analgesic request in naloxone group compared with the control group (P<0.01). Regarding secondary outcomes, there was a highly significant decrease in postoperative opioid consumption in naloxone group compared with the control group (P<0.01), and nonsignificant difference regarding nausea and vomiting (P>0.05). Conclusion Ultra-low-dose naloxone usage in TAP block helps in reducing postoperative pain scores and postoperative opioid consumption in patients who underwent laparoscopic cholecystectomy.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed51    
    Printed2    
    Emailed0    
    PDF Downloaded13    
    Comments [Add]    

Recommend this journal