Impact of Preoperative versus Postoperative Rectus Sheath Block on Analgesic Outcomes

Bi Lin; Liang Qi; Xuejiao Liu; Liangrong Wang

doi:10.54097/nzrwaa92

Authors

Bi Lin
Liang Qi
Xuejiao Liu
Liangrong Wang

DOI:

https://doi.org/10.54097/nzrwaa92

Keywords:

Rectus Sheath Block, Laparoscopic Colorectal Operation, Postoperative Analgesia

Abstract

Objective This study aimed to determine the optimal timing for administering ultrasound-guided rectus sheath block in patients undergoing laparoscopic colorectal surgery. Methods A total of 60 patients who were scheduled to receive laparoscopic radical resection for colorectal cancer were randomly assigned to either Group A or Group B.Group A received the rectus sheath block under ultrasound guidance before surgery, while Group B received the same intervention after surgery.The two groups were compared in terms of Visual Analogue Scale (VAS) scores assessed both at rest and with movement at three time points: 10 minutes after tracheal extubation (T1), 24 hours post-surgery (T2), and 48 hours post-surgery (T3).Recorded parameters also included mean arterial pressure (MAP) and heart rate (HR) measured before and after skin incision. Additional analyses covered intraoperative propofol and remifentanil consumption, the need for rescue analgesia after surgery, perioperative Quality of Recovery-15 (QoR-15) scores, Pittsburgh Sleep Quality Index (PSQI) on postoperative day one, and the occurrence of postoperative nausea and vomiting. Results In both groups, VAS scores at rest and during activity recorded at T2 and T3 were significantly lower than those measured at T1 (P < 0.05). At T1, Group A showed significantly lower VAS scores than Group B under both resting and active conditions (P < 0.05). However, no significant intergroup differences were observed at T2 or T3. Group A also experienced a significantly longer interval before the first request for patient-controlled analgesia, as well as a reduced duration of stay in the post-anesthesia care unit (PACU) and better PSQI scores (P < 0.001). Compared with Group B, Group A had significantly reduced intraoperative use of propofol and remifentanil, along with a lower post-incision mean arterial pressure (P < 0.05). Conclusion Administering ultrasound-guided rectus sheath block prior to surgery offers better early postoperative pain control for patients receiving laparoscopic radical resection of colorectal cancer, decreases the need for intraoperative general anesthetics, and enhances postoperative sleep quality.

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