Comparison of ultrasound-guided TAPB and rectus sheath block combined with dexmedetomidine in patients undergoing transumbilical single-port laparoscopic surgery

INTRODUCTION: To evaluate the efficacy of ultrasound-guided transversus abdominis plane block (TAPB) and rectus sheath block (RSB) combined with dexmedetomidine in patients undergoing transumbilical single-port laparoscopic surgery (TSLS). PATIENTS AND METHODS: A total of 120 patients scheduled for TSLS at Shenzhen Hospital (Futian) of Guangzhou University of TCM from October 2023 to October 2024 were randomly allocated into three groups: Group A (n = 40) received general anaesthesia, Group B (n = 40) received general anaesthesia plus TAPB and Group C (n = 40) received general anaesthesia plus RSB. We assessed intraoperative sufentanil dosage, Visual Analogue Scale (VAS) scores at 6 and 24 h post-surgery, the requirement for rescue analgesia within 24 h, sleep disturbance scores, Ramsay sedation scores at 6 and 24 h post-surgery and the incidence of adverse reactions. RESULTS: There was no significant difference in intraoperative sufentanil dosage amongst the groups (P > 0.05). VAS scores at 6 h and 24 h post-surgery and the rate of rescue analgesia within 24 h were significantly lower in Group C compared to Group B and Group A (P < 0.05). Sleep disturbance scores in Group C were also significantly lower than those in Group B and Group A at 6 h (P < 0.05). The incidence of adverse reactions was significantly lower in Group C compared to Group B and Group A (P < 0.05). CONCLUSIONS: Ultrasound-guided RSB combined with dexmedetomidine is superior to TAPB in reducing post-operative pain, decreasing the need for remedial analgesia, minimally impacting post-operative sleep and reducing the incidence of adverse reactions.