Prosound alpha7 premier

After induction of general anesthesia, RSB was performed immediately on both sides of the linea alba from just below the xiphoid process to the lower part of the umbilicus, where the skin incision was made. RSB was performed by a single anesthesiologist bilaterally under ultrasound guidance (ProSound Alpha7 Premier, Hitachi Aloka Medical, Japan) with a broadband (4–13 MHz) linear array ultrasound probe. Patients in group A were given 40 mL 0.375% ropivacaine and patients in group B were given 40 mL normal saline. The procedure was divided into 3 or 4 injection sites on the left and right sides of the surgical site. Ultrasonography was performed to confirm that the drug was uniformly distributed throughout the skin incision.

In all surgeries, the TAP block was performed twice (after induction of general anesthesia and before awakening from general anesthesia). All surgeries and TAP blocks were performed in the lateral decubitus position with a slight table break at the waist.
All study procedures were performed by one of the study authors (with more than 10 years of experience in ultrasound procedures), including injecting 20 mL of 0.375% ropivacaine or normal saline into the TAP space under ultrasound guidance (ProSound Alpha7 Premier; Hitachi Aloka Medical, Tokyo, Japan) using a broadband (4–13 MHz) linear array ultrasound probe. Both the subcostal and lateral approaches were used to sufficiently cover the entire surgical site of the laparoscopic nephrectomy.^{[10 (link)]} The subcostal approach targets the TAP compartment of the anterior abdominal wall (between the xyphoid process and the anterosuperior iliac spine), whereas the lateral approach targets the TAP compartment of the lateral abdominal wall (between the mid-axillary and anterior axillary lines). Drug injection was performed at 3 to 5 sites, and an ultrasound scan was performed to confirm that the drug was evenly distributed throughout the skin incision.