超声引导下经腹平面阻滞在腹股沟疝修补术后镇痛中的应用

D. Sharma, V. Singh, Alokik Mahajan
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引用次数: 0

摘要

背景:腹股沟疝修补术后疼痛的传统处理方法是局部麻醉伤口浸润。然而,超声引导的腹横平面(TAP)阻滞最近被精确地用于实现术后疼痛的有效控制。目的:评价超声引导下TAP阻滞用于腹股沟疝修补术患者术后镇痛的效果。设置和设计:这是一项基于机构的随机前瞻性临床研究。材料与方法:将成年患者随机分为布比卡因阻断TAP组(T组)和对照组(C组)。评估两组患者术后视觉模拟评分、首次抢救镇痛时间、首次抢救剂量时视觉模拟评分及总抢救剂量。统计分析方法:采用独立t检验、Fisher精确检验和卡方检验对数据进行分析。P <0.05为差异有统计学意义。结果:两组间的人口学特征无统计学差异。两组比较,T组到第一次抢救镇痛剂量的时间较C组长(P = 0.01)。术后12小时内,T组VAS评分和总抢救镇痛消耗低于C组。结论:TAP阻滞是术后疼痛控制的有效工具。利用实时超声成像技术,安全、简便地完成了该手术。
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Ultrasound-guided transversus abdominis plane block for post-operative analgesia in inguinal hernia repair
Context: Postoperative pain for inguinal hernia repair has been traditionally managed with infiltration of the wound with a local anesthetic. However, ultrasound-guided transversus abdominis plane (TAP) block has recently been used with precision to achieve effective control of postoperative pain. Aims: To evaluate the efficacy of ultrasound-guided TAP block for postoperative analgesia in patients undergoing inguinal hernia repair. Settings and Design: This was institutional-based randomized prospective clinical study. Materials and Methods: Adult patients were randomly allocated into those who received TAP block with bupivacaine (group T) and control group C was managed with rescue analgesia. Postoperative visual analogue score, time to first rescue analgesia, visual analogue score at first rescue dose, and total rescue doses consumed were assessed for both the groups. Statistical Analysis Used: Independent t-test, Fisher's exact test, and Chi-square test were used to analysis the data. P <0.05 was considered statistically significant. Results: There was no statistical difference for the demographic profile among the groups. On comparing the two groups, time to first rescue analgesia dose was longer in group T compared to group C (P = 0.01). Postoperative VAS scores and total rescue analgesia consumption was lower for the T group compared to group C up to 12 hours. Conclusions: TAP block is an effective tool in postoperative pain control. It is safe and easy to accomplish this block with the real-time ultrasonography.
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