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

Prajjwal Raj Bhattarai, Anuj Jung Rayamajhi, Rupesh Kumar Yadav, Subash Chandra Paudel, Anang Pangeni, Bikram Byanjankar, Rabin Pandit

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.


Keywords


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

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DOI: http://dx.doi.org/10.3126/jsan.v4i1.17384

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Journal of Society of Anesthesiologists of Nepal (JSAN)

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