Abstract: Objective: To explore the effects of general anesthesia combined with rectus sheath block(RSB) or transverse abdominis plane block(TAPB) on the early pain of the patients after cytoreductive surgery combined with hyperthermie intraperitoneal chemotherapy (CRS/HIPEC), and to provide a reference for performing more optimized anesthesia and analgesia program. Methods: A retrospective cohort study was conducted and the patients underwent CRS/HIPEC in our hospital were selected. The information of anesthesia method was collected by inquiring anesthesia record sheet. According to the different anesthesia methods, the patients were divided into simple general anesthesia group(n=202), general anesthesia combined with RSB group (RSB group) (n=62)and general anesthesia combined with TAPB group (TAPB group)(n=54). Using propensity score to match the general data of three groups, 35 patients in each group were matched. The patients in three groups received the same general anesthesia plan. In RSB group, 0.375% ropivacaine hydrochloride 20 mL was given to the posterior sheath of bilateral rectus abdominis of the patients, and in TAPB group, 0.375% ropivacaine hydrochloride 20 mL was given to the plane of bilateral transverse abdominis of the patients. The changes of hemodynamic indexes, the whole time of operation, the time of extubation after operation, the incidence of hypertension, emergence agitation, nausea and vomiting during the recovery period of anesthesia, the total amount of remifentanil and the total amount of muscle relaxant during operation of the patients in three groups were recorded. All patients in three groups were given patient controlled intravenous analgesia(PCIA), and visual analogue score (VAS), PCIA input dose and pressing times of the patients were recorded at 2, 6 and 12 h after operation. Results: There were no significant differences in baseline data among three groups(P>0.05). and there were no significant differences in the hemodynamic indexes and operation time(P>0.05). The extubation time, remifentanil dosage and muscle relaxant dosage of the patient in RSB group and TAPB group were significantly lower than those in simple general anesthesia group(P<0.05). The incidence of hypertension, emergence agitation, nausea and vomiting in recovery period of the patients in RSB group and TAPB group were significantly lower than those in simpe general anesthesia group(P<0.05). Compared with simple general anesthesia group, the VAS, the PCIA input doses and pressing times of the patients in RSB group and TAPB group were significantly decreased in 2 and 6 h after operation(P<0.05). Conclusion: General anesthesia combined with RSB and general anesthesia combined with TAPB in the CRS/HIPEC operation mode can maintain the hemodynamic stability of the patients during operation, and the early postoperative analgesia effect of the patients is better, so it is a more optimized anesthesia scheme.

Key words: cytoreductive surgery, hyperthermie intraperitoneal chemotherapy, rectus sheath block, transverse abdominis plane block, ultrasound examiation