ObjectiveTo investigate the efficacy of ultrsound-guided continuous transversus abdominis plane block of postoperative analgesia in patients undergoing laparoscopic colorectal surgery. MethodsEighty patients undergoing elective laparoscopic colorectal surgery were randomly assigned to receive continuous transversus abdominis plane analgesia（TAP group）or epidural analgesia（PCEA group）, The TAP group received ultrsound-guided continuous transversus abdominis plane blocks on each side postoperatively（a total of 2.5 mg/kg ropivacaine 0.375%）and bilateral lateral transversus abdominis plane catheters that were infused with ropivacaine 0.2% at a rate of 6 to 8 ml/h for 48 h. The PCEA group received an infusion of ropivacaine 0.15% and fentanyl 3μg/mL for 48 h.The pain score of visual analogue scale（VAS） on couging and at rest were evaluated at 2,6,12,24,36,and 48h after operation. The changes of TAP block level were recorded after operation.Surgical outcome measures included time to walk, time to pass flatus, time for removal of the urinary catheter and patient satisfaction at 48 h. Any complications were also recorded. ResultsThe operation time, intraoperative blood loss, intraoperative crystal infusion and the total volume of infusion did not show significant difference between the groups（P＞0.05）. The volume of colloid fluid infusion in TAP group was less than PCEA group（P＜0.05）. The procedure time of TAP block was longer than PCEA group（P＜0.05）.The variability in VAS scores fell over time and the VAS scores were higher on coughing than at rest between two groups postoperatively. However,we found no significant difference in median visual analogue scores both at rest and on coughing（P＞0.05）between the TAP group and the PCEA group over time .The lateral-to-medial continuous TAP block covered T9～L1, The abdomen sensory block plane were no significant differences compared with 2 h after surgery over time（P＞0.05）. Tramadol consumption, time to pass flatus, time to get out of bed and length of hospital stay did not show significant difference between the groups. There was,however, a significant difference between the groups for the time of removal of the urinary catheter（P＜0.05）. The incidence of naucea,vomiting and sensory disturbance in PCEA group were higher than in TAP group in the first 48 h postoperatively（P＜0.05）.The rate of incomplete analgesia, analgesic failure, patient satisfaction did not show significant difference between the groups（P＞0.05）. ConclusionsThe lateral-to-medial continuous transversus abdominis plane infusion can provide comparable analgesia to epidural infusionin patients after laparotomy colorectal surgery and have less incidence of side-effect.

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