Objective  To investigate the value of transversus abdominis plane block (TAPB) combined with incision local infiltration anesthesia used in patients with hepatocellular carcinoma for recovery after surgery.

  Methods  Sixty patients with liver cancer undergoing abdominal surgery under general anesthesia were randomly divided into two groups (n=30 each): general anesthesia combined with TAPB and incision local infiltration anesthesia group (group T) and control group, i.e., general anesthesia alone (group C). Perioperative hemodynamic changes, postoperative patient-controlled intravenous analgesia (PCIA) use (number of presses), intraoperative sevoflurane use, and remifentanil dosage were recorded. The postoperative recovery time; visual analog scale (VAS) score at 2, 4, 6 h, and 24 h postoperatively; adverse reaction rate; level of inflammatory factors; and patient rehabilitation were compared between the two groups.

  Results  In group T, perioperative hemodynamics were more stable than in group C. The anesthetic dosage, recovery time, extubation time, and incidence rate of adverse reactions in group T were significantly lower than those in group C (P < 0.05). The VAS scores at 2, 4, and 6 h after surgery were reduced (P < 0.05), and the times of additional PCIA uses were fewer (P < 0.05) in group T than in group C. The levels of the inflammatory factors CRP, TNF-α, and IL-6 at 4 and 24 h postoperatively were significantly lower in group T than in group C (P < 0.05). In addition, in group T, the postoperative ambulation time (26.2±7.6) vs. (37.2±10.4) h, gastrointestinal recovery time (37.8±13.1) vs. (44.7±13.7) h, and postoperative hospitalization time (6.1±0.7) vs. (8.1±0.9) d were shorter than those for group C (P < 0.05).

  Conclusions  Ultrasound-guided TAPB combined with ropivacaine local incision infiltration can reduce sensitivity to noxious stimulation and pain, stabilize perioperative hemodynamics, reduce fentanyl anesthetic dosage, shorten recovery time, reduce the probability of adverse reactions, and reduce the release of inflammatory cytokines, thereby rapidly improving the rehabilitation of patients.