Rectus Sheath Block (RSB) Analgesia Could Enhance Significantly the Patient Satisfaction Following Midline Laparotomy in Benign Disease and in Cancer: A Prospective Study With Special Reference to Nitrosative Stress Marker Nitrotyrosine (NT) Plasma Concentrations

Anticancer Res. 2019 Mar;39(3):1383-1389. doi: 10.21873/anticanres.13252.

Abstract

Background/aim: Our hypothesis was that rectus sheath block (RSB) analgesia could enhance satisfaction following midline laparotomy in patients with benign disease and cancer patients.

Patients and methods: Initially, 56 patients were randomized into four groups; control group (n=12), single-dose (n=16), repeated-dose (n=12) and continuous infusion (n=16) RSB analgesia groups. The plasma concentrations of the NT marker were measured just before, immediately after and 24 h after operation. Patient satisfaction at 24 h postoperatively was filed on a 11-point numeric rating scale (SFS24; 0=fully unsatisfied; 10=fully satisfied).

Results: The RSB analgesia significantly enhanced the SFS24 scores in the study groups (p=0.001). The median plasma NT concentrations (pg/ml) following surgery (POP1) were significantly lower in patients with cancer versus patients with benign disease (5.3 vs. 7.6, p=0.008). Jitter plots of the individual SFS24 values versus plasma NT concentrations were significantly correlated in benign and cancer patients (r=-0.284, p=0.028).

Conclusion: The RSB analgesia could significantly enhance patient satisfaction following midline laparotomy. Plasma NT concentrations versus patient satisfaction following surgery are significantly correlated in benign disease and cancer.

Keywords: Benign disease; cancer; nitrosative stress; plasma nitrotyrosine; satisfaction following surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Analgesia
  • Female
  • Humans
  • Laparotomy
  • Male
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / surgery*
  • Nerve Block*
  • Nitrosative Stress
  • Rectus Abdominis*
  • Tyrosine / analogs & derivatives*
  • Tyrosine / blood

Substances

  • 3-nitrotyrosine
  • Tyrosine