Modified thoracoabdominal nerves block through perichondrial approach for surgical patients: a scoping review.

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY BMC Anesthesiology Pub Date : 2024-12-28 DOI:10.1186/s12871-024-02878-y
Nobuhiro Tanaka, Mitsuru Ida, Takanori Suzuka, Masahiko Kawaguchi
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Abstract

Background: Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) is a trunk block that has been gaining attention for managing postoperative pain following abdominal surgeries since its first report in 2019. We conducted a scoping review on M-TAPA, aiming to comprehensively evaluate existing research, identify the gaps in knowledge, and understand the implications of M-TAPA.

Methods: This scoping review was conducted using databases including PubMed, Embase, Cochrane, and CINAHL to evaluate the clinical efficacy of M-TAPA on April 19, 2024. Background and outcomes including anesthetized dermatomes, postoperative pain, opioid consumption, quality of recovery, duration to perform, and plasma local anesthetic concentrations were assessed. All reports involving patients, including randomized controlled trials, observational studies, case series, and case reports regarding M-TAPA, were included without language or age restrictions. The included studies were analyzed based on their methodology and clinical relevance.

Results: Anesthetized dermatomes were mainly observed in anterior cutaneous branch T7-11. Lateral cutaneous branch T8-10 also anesthetized; however, the probability was lower than anterior cutaneous branch area. M-TAPA has been investigated mostly in laparoscopic cholecystectomy; although its potential to outperform non-block and wound infiltration has been suggested, it did not clearly outperform the transversus abdominis plane block.

Conclusions: M-TAPA may be considered a promising technique for postoperative pain management in upper abdominal laparoscopic surgeries. Further studies are warranted to elucidate the precise mechanisms and broader surgical applications.

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改良胸腹神经阻滞术经硬膜周围入路用于外科患者:范围回顾。
背景:经软膜外入路改良胸腹神经阻滞(M-TAPA)是一种主干阻滞,自2019年首次报道以来,一直受到腹部手术术后疼痛治疗的关注。我们对M-TAPA进行了范围综述,旨在全面评估现有研究,确定知识空白,并了解M-TAPA的含义。方法:采用PubMed、Embase、Cochrane、CINAHL等数据库,于2024年4月19日评价M-TAPA的临床疗效。评估背景和结果,包括麻醉皮肤、术后疼痛、阿片类药物消耗、恢复质量、手术持续时间和血浆局麻药浓度。所有涉及患者的报告,包括随机对照试验、观察性研究、病例系列和关于M-TAPA的病例报告,均纳入无语言或年龄限制。纳入的研究根据其方法学和临床相关性进行分析。结果:麻醉皮屑主要分布在皮前支T7-11。外侧皮支T8-10也麻醉;但在皮前支区出现的概率较低。M-TAPA主要用于腹腔镜胆囊切除术;虽然它有可能优于非阻滞和伤口浸润,但它并没有明显优于腹横面阻滞。结论:M-TAPA可能被认为是上腹部腹腔镜手术术后疼痛管理的一种有前途的技术。需要进一步的研究来阐明确切的机制和更广泛的外科应用。
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来源期刊
BMC Anesthesiology
BMC Anesthesiology ANESTHESIOLOGY-
CiteScore
3.50
自引率
4.50%
发文量
349
审稿时长
>12 weeks
期刊介绍: BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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