Department of Upper Gastrointestinal Surgery, Frenchay Hospital, Frenchay Park Road, Bristol, BS16 1LE, UK.
Obes Surg. 2011 Mar;21(3):278-82. doi: 10.1007/s11695-010-0203-2.
The transversus abdominis plane (TAP) block acts on the nerves localised in the anterior abdominal wall muscles. We evaluated the efficacy on post-bariatric (PB) patients undergoing body-contouring abdominoplasty. We retrospectively evaluated PB patients undergoing abdominoplasty with flank liposuction and compared results to a matched group of TAP aesthetic patients. Outcomes evaluated were the analgesic requirements during the early postoperative days. Fifty-one patients (PB n = 27, aesthetic n = 24) were assessed. No complications were observed. All PB patients required analgesia until the second postoperative day contrarily to most aesthetic ones. Patients with greater flap resected and higher pre-abdominoplasty BMI had greater morphine consumptions. In PB patients, the larger amount of tissues resected corresponded to a greater stimulation of pain fibres that cannot be paralleled by a concomitant increase of the local anesthetic administered. This partially invalidates TAP's efficacy on PB patients.
腹横肌平面 (TAP) 阻滞作用于位于前腹壁肌肉中的神经。我们评估了其对接受减重（PB）后行身体塑形腹部整形术患者的疗效。我们回顾性评估了接受侧腹抽脂腹部整形术的 PB 患者，并将结果与 TAP 美容患者的匹配组进行比较。评估的结果是术后早期的镇痛需求。评估了 51 名患者（PB n=27，美容 n=24）。未观察到并发症。所有 PB 患者均需要镇痛至术后第 2 天，而大多数美容患者则不需要。切除的皮瓣越大、术前 BMI 越高的患者，吗啡用量越大。在 PB 患者中，切除的组织量越大，对痛觉纤维的刺激就越大，而同时给予的局部麻醉剂却不能相应增加。这在一定程度上否定了 TAP 对 PB 患者的疗效。
