Objective:

To investigate the analgesic effect and safety of ultrasound-guided transversus abdominis plane (TAP) block combined with local anesthesia for microwave ablation (MWA) of liver cancer.

Methods:

Patients with primary liver cancer and metastatic liver cancer who underwent ultrasound-guided MWA after ultrasound-guided TAP bloc

k combined with local anesthesia in Jiangsu Cancer Hospital from November 2021 to June 2023 were retrospectively analyzed. According to the ablation site and range of preoperative ipsilateral subcostal margin + Petit triangle dual access TAP block combined with local anesthesia

and ultrasound-guided TAP in-plane injection of 0.375% ropivacaine 20 mL

and patients were evaluated by using numerical rating scale (NRS) to assess the pain level in the intraoperative period

and the postoperative period of 30 min

1 h

3 h

6 h

12 h and 24 h. The pain level of the block was observed. The pain level of the patients was evaluated using the numerical rating scale (NRS) during the operation

30 min

1 h

3 h

6 h

12 h and 24 h after the operation

and the block efficiency

complication occurrence

and the amount of remedial analgesic used during and after the operation were observed.

Results:

All 13 patients with primary liver cancer and metastatic liver cancer underwent MWA in 1 session

and TAP block combined with local anesthesia was successfully performed. Three (23.1%) patients had mild pain (NRS) without intervention; one (7.7%) patient had moderate pain

and the ablation was completed with intramuscular analgesic drugs. Postoperatively

3 (23.1%) patients had mild pain without intervention

all of which resolved spontaneously within 6 h. There were no intraoperative or postoperative complications related to TAP block. All patients were 100.0% satisfied with the effect of TAP block combined with local anesthesia for 24 h after ablation.

Conclusion:

Ultrasound- guided TAP block combined with local anesthesia is safe and effective in MWA of liver cancer

broadening the application range of MWA of liver cancer.