RSB is a useful component of the multimodal analgesia after midline laparotomy. It enhances PS when given repeatedly or as a continuous infusion. The postoperative opioid consumption does not diminish markedly but RSB helps to prevent extreme opioid consumption. RSB with levobupivacaine appears to be safe, at least for 48h. Continuous infusion and repeated doses schema seem to be reasonable alternatives to TEA after a midline laparotomy.
Conclusions:
1. Placement of RSB analgesia does not significantly alter the oxidative stress marker 8-OHdG concentrations in patients with benign disease or cancer. There is no significant correlation between the individual values of PS of postoperative analgesia and 8-OHdG postoperatively.
2. Placement of RSB analgesia does not significantly reduce the inflammatory biomarkers concentrations in patients with benign disease or cancer. There is a significant correlation between the individual values of PS of postoperative analgesia and postoperative IL-10 concentrations and between PS of postoperative analgesia with postoperative concentrations of IL-1𝛽𝛽.
3. There is no statistical significant correlation in PS of postoperative analgesia between patients with benign disease and cancer patients, nor between PS and plasma concentrations of GPX1.
4. RSB with repeated-dose and continuous infusion administrations provides slightly decreased opioid consumption (not reaching the statistical significance) during the first 12 hours and enhanced PS with pain treatment after midline laparotomy.
duration of postoperative ileus (Rimbäck et al. 1986; 1988; 1990), and therefore its possible
AE on anastomotic healing should be investigated.
7 Summary and conclusions
RSB is a useful component of the multimodal analgesia after midline laparotomy. It enhances PS when given repeatedly or as a continuous infusion. The postoperative opioid consumption does not diminish markedly but RSB helps to prevent extreme opioid consumption. RSB with levobupivacaine appears to be safe, at least for 48h. Continuous infusion and repeated doses schema seem to be reasonable alternatives to TEA after a midline laparotomy.
Conclusions:
1. Placement of RSB analgesia does not significantly alter the oxidative stress marker 8-OHdG concentrations in patients with benign disease or cancer. There is no significant correlation between the individual values of PS of postoperative analgesia and 8-OHdG postoperatively.
2. Placement of RSB analgesia does not significantly reduce the inflammatory biomarkers concentrations in patients with benign disease or cancer. There is a significant correlation between the individual values of PS of postoperative analgesia and postoperative IL-10 concentrations and between PS of postoperative analgesia with postoperative concentrations of IL-1𝛽𝛽.
3. There is no statistical significant correlation in PS of postoperative analgesia between patients with benign disease and cancer patients, nor between PS and plasma concentrations of GPX1.
4. RSB with repeated-dose and continuous infusion administrations provides slightly decreased opioid consumption (not reaching the statistical significance) during the first 12 hours and enhanced PS with pain treatment after midline laparotomy.
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Ballou MA, Sutherland MA, Brooks TA, et al. Administration of anesthetic and analgesic prevent the suppression of many leucosyte responses following castration and physical dehorning. Vet Immunol Immunopathol. 2013; 151: 285-93.
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Beard TL, Leslie JB, Nemeth J. The opioid component of delayed gastrointestinal recovery after bowel resection. J Gastrointest Surg. 2011; 15: 1259-68.
Beaussier ME, El’Ayobi H, Schiffer E, et al. Continuous preperitoneal infusion of ropivacaine provides effective analgesia and accelerates recovery after colorectal surgery:
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Berland D, Rodgers P. Rational use of opioids for management of chronic nonterminal pain. Am Fam Physician. 2012 Aug 1; 86(3): 252-58.
Berman JW, Guida MP, Warren J, et al. Localization of monocyte chemoattractant peptide-1 expression in the central nervous system in experimental autoimmune encephalomyelitis and trauma in the rat. J Immunol. 1996; 156: 3017–23.
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Bisgaard T, Klarskov B, Kristiansen VB, et al. Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study. Anesth Analg. 1999 Oct; 89(4): 1017-24.
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Boom M, Olofsen E, Neukirchen M, et al. Fentanyl utility function: a risk-benefit composite of pain relief and breathing responses. Anesthesiology. 2013 Sep; 119(3): 663-74.
Brejvik EK, Björnsson GA, Skovlund E. A comparison of pain rating scales by sampling from clinical trial data. Clin J Pain. 2000; 16: 22–8.
Burke D, MacKenzie M, Newton D, et al. A comparison of vasoactivity between levobupivacaine and bupivacaine. Br J Anaesth. 1998; 81(4); 631-2.
Capogna G, Celleno D, Fusco P, et al. Relative potencies of bupivacaine and ropivacaine for analgesia in labor. Br J Anaesth. 1999; 82: 371-3.
Casati A, Vinciguerra F, Cappelleri G, et al. Levobupivacaine 0.2% or 0.125% for continuous sciatic nerve block: a prospective, randomized, double-blind comparison with 0.2% ropivacaine. Anesth Analg. 2004; 99: 919-23.
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Charlton S, Cyna AM, Middleton P, et al. Perioperative transversus abdominis plane (TAP) blocks for analgesia after abdominal surgery. Cochrane Database Syst Rev. 2010 Dec; 8(12).
Chen WK, Ren L, Wei Y, et al. General anesthesia combined with epidural anesthesia ameliorates the effect of fast-track surgery by mitigating immunosuppression and facilitating intestinal functional recovery in colon cancer patients. Int J Colorectal Dis.
2015; 30: 475-81.
Chung MH, Kim HS, Ohutsuka E, et al. An endonuclease activity in human polymorphonuclear neutrophils that removes 8-hydroxyguanine residues from DNA+.
Biochem Biophys Res Commun. 1991; 178: 1472-78.
Copray JC, Mantingh I, Brouwer N, et al. Expression of interleukin-1 beta in rat dorsal root ganglia. J Neuroimmunol. 2001; 118: 203–11.
Courreges P, Poddevin F, Lecoutre D. Para-umbilical block: A new concept for regional anaesthesia in children. Paediatr Anaesth. 1997; 7: 211-4.
Crosbie EJ, Massiah NS, Achiampong JY, et al. The surgical rectus sheath block for post-operative analgesia: a modern approach to an established technique. Eur J Obstet Gynecol Reprod Biol. 2012 Feb; 160(2): 196-200.
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