单侧腹股沟疝修补术中先发制人静脉镇痛与术后TAP阻断的疗效评价——一项前瞻性随机双盲临床试验

C. Navya, V. Srisanthanakrishnan, P. M. Safneedha, V. Ranganathan
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摘要

摘要目的本研究的目的是比较腹股沟疝成形术患者先发制人镇痛和经腹平面(TAP)阻滞在镇痛持续时间和术后镇痛药物需求方面的程度。材料与方法90例年龄在18 ~ 65岁之间的美国麻醉学会I级和II级男性腹股沟疝切开成形术患者随机分为3组,每组30例。对照组(C组)给予生理盐水;先发制人组(P组)注射j。扑热息痛,inj。双氯芬酸和注射。利多卡因;TAP组(T组)术后用0.25%布比卡因阻断TAP 20 mL。记录的参数包括休息时4、12、24和48小时的口头数值评定量表(VNRS)和运动时12、24和48小时的VNRS;0、4、12和48小时心率和平均动脉压;首次请求镇痛的时间;以及24小时内止痛药的总剂量。结果人口统计学数据具有可比性。T组24小时运动VNRS和使用镇痛药剂量数(4.80±0.761)明显低于T组;与其他组相比,该组首次要求镇痛的时间更长,患者满意度得分更高。结论P组和T组的VNRS评分均高于c组。TAP阻滞组在24小时运动VNRS评分、镇痛需求和患者满意度评分均高于其他组。
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Evaluation of Effectiveness of Preemptive Intravenous Analgesics versus Postoperative TAP Block in Unilateral Inguinal Hernioplasty—A Prospective Randomized Double-Blind Clinical Trial
Abstract Aim  The aim of this study was to compare the extent of analgesia in terms of duration of analgesia and requirement of postoperative analgesics with preemptive analgesia and transversus abdominis plane (TAP) block in patients undergoing inguinal hernioplasty. Materials and Methods  Ninety male patients aged between 18 and 65 years of American Society of Anesthesiologists grades I and II undergoing open inguinal hernioplasty were randomly allocated to three comparable groups of 30 each. Control group (group C) received normal saline; preemptive group (group P) received inj. paracetamol, inj. diclofenac, and inj. Lignocaine; and TAP group (group T) received TAP block with 20 mL of 0.25% bupivacaine at the end of surgery. Parameters recorded were verbal numerical rating scale (VNRS) at rest at 4, 12, 24, and 48 hours and VNRS on movement at 12, 24, and 48 hours; heart rate and mean arterial pressure at 0, 4, 12, and 48 hours; time for first analgesic request; and total doses of analgesics consumed at 24 hours. Results  Demographic data were comparable. VNRS on movement and number of doses of analgesics consumed at 24 hours were statistically less in group T (4.80 ± .761 hours); time for first request of analgesia was longer and this group had better patient satisfaction scores compared with other groups. Conclusion  Both groups P and T provided better VNRS scores compared with group C. TAP block provided better VNRS scores on movement at 24 hours, lesser analgesic requirement, and better patient satisfaction score compared with other groups.
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