髂腹股沟-髂腹下神经与肋间神经联合阻滞对肾移植受者术后疼痛缓解的疗效
The efficacy of ilioinguinal-iliohypogastric and intercostal nerve co-blockade for postoperative pain relief in kidney recipients.
作者信息
Shoeibi Gita, Babakhani Babak, Mohammadi Sussan Soltani
机构信息
Department of Anesthesiology, Dr Shariati Hospital, Tehran, Iran.
出版信息
Anesth Analg. 2009 Jan;108(1):330-3. doi: 10.1213/ane.0b013e31818c1b13.
BACKGROUND
Postoperative pain is severe in patients undergoing renal transplantation. Systemic analgesia may produce complications as a result of impaired renal function. We investigated whether combined lower intercostal and Ilioinguinal-Iliohypogastric (IG-IH) nerve block might improve the quality of analgesia and reduce morphine consumption during the first 24 h after surgery.
METHODS
Forty-two patients, scheduled as kidney transplant recipients were randomized into two equal groups and were anesthetized with the same technique. After surgery IG-IH, T11 and T12 intercostal nerves on the side of surgery were blocked by bupivacaine 0.5%. The control group was not blocked. Postoperative pain and total amount of morphine consumption were recorded by a person who was blinded to the allocation.
RESULTS
There were significant differences in median visual analog scale scores (25th-75th) measurements at all time points in the study groups (P < 0.05). The total amount of morphine consumption during 24 h was 12.7 +/- 10.5 mg in the blocked group compared with 34.9 +/- 5.9 mg in the nonblocked group (P < 0.001).
CONCLUSIONS
Combined IG-IH and lower intercostal nerves blockade after renal transplantation significantly reduced postoperative pain and opioid consumption.
背景
肾移植患者术后疼痛剧烈。由于肾功能受损，全身镇痛可能会产生并发症。我们研究了联合下肋间神经和髂腹股沟-髂腹下神经（IG-IH）阻滞是否能改善镇痛质量并减少术后24小时内的吗啡用量。
方法
将42例计划接受肾移植的患者随机分为两组，采用相同技术进行麻醉。术后用0.5%布比卡因阻滞手术侧的IG-IH、T11和T12肋间神经。对照组不进行阻滞。由对分组不知情的人员记录术后疼痛情况和吗啡总用量。
结果
研究组在所有时间点的视觉模拟量表评分中位数（第25-75百分位数）测量值存在显著差异（P<0.05）。阻滞组24小时内吗啡总用量为12.7±10.5毫克，非阻滞组为34.9±5.9毫克（P<0.001）。
结论
肾移植后联合IG-IH和下肋间神经阻滞可显著减轻术后疼痛并减少阿片类药物用量。
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