Application of blockade of the rectal abdominal muscle vagina for a «salvage» anesthesia after median laparotomy in patients with obesity

Abstract

Objective. To estimate the analgetic efficacy and possibility of application of bilateral dual blockade of a rectal abdominal muscle vagina (RSB) as a «salvage» anesthesia after laparotomic operations in patients with obesity. Маterials and methods. In 16 patients with obesity the complexity of performance, аnalgetic efficacy and possibility of the RSB application as a «salvage» method of anesthesia after laparotomic operations were estimated. Results. There was established, that, using ultrasonographic support, it is simple to perform RSB in 75% patients, the procedure lasts 5 - 10 min, with general success rate of anesthesia - 94%, аdequate analgesia occurs in - (3 ± 1.5) min after a blockade conclusion. Postoperative application of RSB reduces the need in opioids in 2 times, and in 4 times - the іncidence of nausea and regurgitation (p < 0.05), promotes activation of patients already on the first day end (p < 0.05), guaranteeing analgetic comfort on level «excellent» or «good» in 100% of the patients (p < 0.05). Conclusion. RSB constitutes a purposeful component of multimodal analgesia after performance of median laparotomy in patients with obesity, which prevents excessive administration of opioids, reduces quantity of adverse events and enhances the anesthesia quality, which was assessed by 100% of the patients as «excellent» or «good».

Keywords

• obesity; median laparotomy; «salvage» anesthesia; blockade of the rectal abdominal muscle vagina.