Comparison of analgesic effects of two local anesthetics in transversus abdominis plane block for postoperative pain management in elderly patients undergoing abdominal surgery
WANG Zhi-ming
WANG Kai
MIAO Qing
LI Shu-yun
Abstract：Objective To compare the analgesic effects of liposomal bupivacaine and ropivacaine in transversus abdominis plane(TAP)block for postoperative pain management in elderly patients undergoing abdominal surgery.Meth-ods A total of 200 elderly patients who underwent abdominal surgery at our hospital from April 2024 to June 2025 were enrolled and randomly assigned(1∶1)into the control group(ropivacaine TAP block)and the observation group(liposo-mal bupivacaine TAP block),with 100 patients in each group.Safety parameters and laboratory indices before and after surgery were compared.Visual analog scale(VAS)pain scores at 6,12,24,48,and 72 hours postoperatively,as well as postoperative pain treatment satisfaction scale(PTSS)scores at 48 hours,were assessed.Opioid consumption,patient-controlled analgesia(PC A)press times,rescue analgesia frequency,recovery-related indicators,adverse reactions,and complications were also recorded and compared.Results Mean arterial pressure(MAP)and heart rate increased signifi-cantly at 72 h postoperatively compared with baseline in both groups,but were lower in the observation group than in the control group(P＜0.05).Resting and dynamic VAS scores decreased sequentially in both groups from 6 to 72 h postoper-atively,with significantly lower scores in the observation group(P＜0.05).PTSS scores were higher in the observation group(P＜0.001).Serum CRP,IL-6,and cortisol levels at 24 h postoperatively were elevated in both groups but were lower in the observation group(P＜0.05).The observation group also showed reduced opioid consumption,fewer PCA press times,and fewer rescue analgesia events,as well as shorter times to first flatus,bowel sound recovery,ambulation,and hospital stay(P＜0.05).The incidence of overall adverse events and complications was not significantly different be-tween groups(P=0.547,0.259).Conclusion In elderly patients undergoing abdominal surgery,liposomal bupiva-caine for TAP block provides superior analgesic efficacy compared with ropivacaine,improves pain control satisfaction,at-tenuates inflammatory responses,and promotes postoperative recovery without increasing adverse events.
Keywords：elderly patientsabdominal surgerytransversus abdominis plane blockliposomal bupivacaineropivacainepostoperative analgesia
Publication Date：2025-10-15
Online Publishing Date：2025-11-28(First online date of this platform, not the publication date of the document)
Pages：6( 1496-1501 )