Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anaesthesia and Pain Relief

Background: Regional analgesia has shown considerable promise in paediatric surgery. Regional analgesia reduces opiate requirements, intraoperative general anaesthetic requirements, improves recovery, and has a proven safety record. Ultrasonography guidance improves the accuracy of the local anaesthetic placement and may further increase safety. The two major types of regional analgesia are neuroaxial {u2013} epidural, spinal or caudal {u2013} and peripheral. Peripheral nerve blocks avoid the potential for spinal haematoma epidural infection. Methods: The study involved two groups of patients who underwent abdominal surgeries using midline or paramedian incisions; the RSB Group (n=25) and the EPB Group (n=25).Both groups are comparable.Results: The two groups had the same effect on pulse rate with no significant difference between the two groups. The two groups had the same effect on pulse rate, however, the MAP was significantly higher in RSB Group. The two groups had the same effect on oxygen saturation with no significant difference between the two groups . The two groups had the same effect on PEFR, however, it was significantly higher in RSB Group Conclusion: We can conclude that rectus sheath block is as effective as epidural block in reduction of pain intensity at rest and with coughing following major abdominal operations in cancer patients. A single shot is effective up to 12 hours postoperatively. Rectus sheath block is associated with hemodynamic stability along the 12 postoperative hours with no drug- or procedure-related adverse events

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