Authors : Upasna V Bhatia, Mona B Panchal, Shyni Abraham, Charmi Shah
DOI : 10.18231/j.ijca.2020.007
Volume : 7
Issue : 1
Year : 2020
Page No : 32-38
Introduction: Ultrasound guided (US) rectus sheath block, blocks ventral rami of 7th to 12th thoracic
nerves by injection of local anaesthetics (LA) into the space between the rectus muscle and posterior
sheath. The aim of the study was to evaluate the analgesic efficacy of Bupivacaine, Levobupivacaine and
Ropivacaine in ultrasound guided bilateral rectus sheath block in patients undergoing umbilical surgeries.
Materials and Methods: Patients received bilateral US-guided injection of total 30 mL of levobupivacaine
(GpL) 0.25 % (or 0.375% of Ropivacaine (GpR) or 0.25%of Bupivacaine (GpB) respectively, behind the
rectus muscle to detach it from its sheath. Analgesic efficacy of LA was evaluated using duration of
analgesia, pain score at extubation and 1-16 hrs postoperatively and mean VAS (visual analogue scale)
score to assess the quality of analgesia.
Results: There were statistically significant differences in VAS scores between the groups L, R and B at all
postoperative time points - 1hr, 2 hr, and 3hr till 16hrs. (P < 0> three groups was 9.300.92 hrs in Gp L, 13.021.17 hrs in Gp R and 6.2 0.83hrs in Gp B respectively.
This difference was statistically significant (p =< 0>
Conclusions: Single shot of different local Anaesthetics in Ultrasound guided bilateral rectus sheath block
provides postoperative analgesia up till 16hrs in patients with BMI 25-40kg/m2 undergoing umbilical
surgeries with excellent VAS scores with Ropivacaine.
Keywords: Umbilical hernia repair, Ultrasound guided rectus sheath block, Levobupivacaine, Ropivacaine, Postoperative analgesia.