• M Mugita, R Kawahara, Y Tamai, K Yamasaki, S Okuno, R Hanada, M Inaoka, and T Funato.
• Department of Rehabilitation, Nissay Hospital, Osaka, Japan.
• Clin Exp Obstet Gyn. 2014 Jan 1;41(6):627-32.

PurposeTo evaluate the effectiveness of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks in pain management and recovery after gynecological single-incision laparoscopic surgery (SILS).Materials And MethodsAbilateral TAP block (Group A, n = 9), bilateral TAP and RS blocks (Group B, n = 10), and a bilateral RS block (Group C, n = 9) with 40 ml ropivacaine per patient were conducted in 28 patients undergoing SILS for ovarian tumors. A pain score and walking distance in a 6-minute walk test (6MWT) were examined.ResultsPain scores were significantly lower on postoperative day (POD) 3 than on POD 1 in Groups B (p = 0.03) and C (p = 0.02). The walking distance on POD 3 was comparable with that before surgery in Group C (p = 0.75), but shorter in Groups A (p = 0.004) and B (p = 0.02).ConclusionsThe RS block alone was the most effective in relieving pain and accelerating general recovery after gynecological SILS.

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