Application of ropivacaine and bupivacaine transversus abdominis plane block combined with general anesthesia in laparoscopic cholecystectomy
Xu Xiaoli
Wang Xiang
Shan Yulan
Zhou Xiaolin
Abstract：Objective Comparison of the effects of ropivacaine and bupivacaine transversus abdominis plane block(TAPB)combined with general anesthesia in laparoscopic cholecystectomy(LC).Methods A total of 98 patients who underwent LC in Hai'an People's Hospital from March 2022 to March 2024 were selected as the research objects and randomly divided into the con-trol group and the observation group by the computer-generated random number table method,and 49 patients who met the inclusion criteria were included in each group.The patients in the control group received bupivacaine TAPB combined with general anesthesia,while those in the observation group received ropivacaine TAPB combined with general anesthesia during surgical treatment.Hemo-dynamics indicators and stress responses at pre-anesthesia(T1),extubation(T2),and 30 minutes after extubation(T3)were compared between the two groups,along with the postoperative pain scores at 2,12,and 24 hours after surgery and the incidence of adverse reactions.Results The mean arterial pressure and heart rates of the observation group at time point T2 were both higher than those in the control group((85.55±8.34)mmHg(1 mmHg≈0.133 kPa)vs(82.08±8.23)mmHg,(79.49±8.01)times·min-1 vs(76.15±8.23)times·min-1,respectively)(t=2.073,2.036,both P<0.05).The cortisol and epinephrine levels at time points T2 and T3 in the observation group were lower than those in the control group((211.25±23.89)μg·L-1 vs(223.25±28.84)μg·L-1,(183.39±17.98)μg·L-1 vs(196.39±19.86)μg·L-1,(1.42±0.11)μg·L-1 vs(1.77±0.13)μg·L-1,(1.09±0.13)μg·L-1 vs(1.31±0.12)μg·L-1,respectively)(t=-2.243,-3.397,-14.387,-8.705,all P<0.05).At 2,12 and 24 hours after surgery,there was no statistically signifi-cant difference in the visual analogue score of venous pain between patients in the observation group and the control group((2.12±0.17)points vs(2.14±0.15)points,(3.87±0.98)points vs(3.94±1.01)points,(3.41±0.78)points vs(3.58±0.97)points,respectively)(t=-0.618,-0.348,-0.956,all P>0.05).The incidence of adverse reactions in the observation group was 8.16%(4/49),which was lower than that in the control group(26.53%(13/49))(χ2=5.765,P<0.05).Conclusion Ropivacaine TAPB combined with general anesthesia demonstrates a better analgesic efficacy in patients undergoing LC,has a small impact on hemodynamics,attenuates stress responses,and has favorable safety.
Keywords：RopivacaineBupivacaineTransversus abdominis plane blockLaparoscopic cholecystectomyPainStress response
Publication Date：2025-09-25
Online Publishing Date：2025-10-10(First online date of this platform, not the publication date of the document)
Pages：4( 1112-1115 )