Comparison of ultrasound-guided abdominal nerve blocks and subarachnoid block as an anaesthetic technique for appendectomy: a retrospective study

Authors

DOI:

https://doi.org/10.3126/jsan.v4i1.17384

Keywords:

appendectomy, coeliac plexus block, rectus sheath block, spinal anaesthesia, transverses abdominis plane block, ultrasound

Abstract

Background: Ultrasound guided abdominal nerve blocks are increasingly being used for anaesthesia and analgesia for surgeries like appendectomy, hernia repair in our centre. The aim of the study was to compare abdominal nerve blocks and subarachnoid block for appendectomy.

Method: Retrospective data of patients that underwent appendectomy either under subarachnoid block (Group-S) or abdominal nerve blocks (Group-A) for three months were collected from hospital records. The groups were compared for conversion to general anaesthesia as a primary end point of study and also for the time taken for the procedure, the first requirement of opioids, total opioid consumption and length of hospital stay.

Result: Out of 116 patients studied, 75 surgeries were performed under subarachnoid block and 41 under abdominal plane blocks. Two patients in Group-S and 1 patient in Group-A were converted to general anaesthesia due to inadequate blockade. The time taken to perform the block was around four minutes in Group-S and 12 minutes in Group-A. The mean pethidine consumption in 24 hours was 62.33+16.63 mg and 23.17+15.19 mg in Group-S and Group-A respectively. The time to the first dose of pethidine in Group-S groups was 224.66+43.56 minutes and 813.17+361.80 minutes in Group-A. The mean duration of hospital stay in Group-S was 5.14+0.72 days and Group-A was 2.24+0.58 days.

Conclusion: Appendectomy can be safely performed under subarachnoid block as well as the abdominal nerve blocks. The abdominal nerve block technique is found to be advantageous in terms of better postoperative analgesia, less opioid consumption and early hospital discharge.

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Author Biographies

Prajjwal Raj Bhattarai, Civil Service Hospital, Min Bhawan, Kathmandu 44600

Department of Anesthesia

Anuj Jung Rayamajhi, Civil Service Hospital, Min Bhawan, Kathmandu 44600

Head, Department of Anesthesia

Rupesh Kumar Yadav, Civil Service Hospital, Min Bhawan, Kathmandu 44600

Department of Anesthesia

Subash Chandra Paudel, Civil Service Hospital, Min Bhawan, Kathmandu 44600

Department of Anesthesia

Anang Pangeni, Civil Service Hospital, Min Bhawan, Kathmandu 44600

Department of Surgery

Bikram Byanjankar, Civil Service Hospital, Min Bhawan, Kathmandu 44600

Department of Surgery

Rabin Pandit, Civil Service Hospital, Min Bhawan, Kathmandu 44600

Department of Surgery

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Published

2017-06-28

How to Cite

Bhattarai, P. R., Rayamajhi, A. J., Yadav, R. K., Paudel, S. C., Pangeni, A., Byanjankar, B., & Pandit, R. (2017). Comparison of ultrasound-guided abdominal nerve blocks and subarachnoid block as an anaesthetic technique for appendectomy: a retrospective study. Journal of Society of Anesthesiologists of Nepal, 4(1), 16–22. https://doi.org/10.3126/jsan.v4i1.17384

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Original Articles