Araco Antonino, Pooney Jack, Araco Francesco, Gravante Gianpiero
Dolan Park Hospital, Bromsgrove, Birmingham, United Kingdom.
Ann Plast Surg. 2010 Oct;65(4):385-8. doi: 10.1097/SAP.0b013e3181cc2a24.
The transversus abdominis plane (TAP) block is a technique of locoregional anesthesia that blocks the sensorial afferent nerves localized between the transversus abdominis muscle and the internal oblique muscle. We describe results obtained with a case control study between patients undergoing abdominoplasty with the TAP block compared with a similar group of patients not receiving the block.
Medical notes were reviewed, and patients were classified according to the presence of TAP. Outcomes evaluated were the requirements of morphine in the first postoperative hour and the number of co-codamol tablets administered afterward.
Seventy-five patients were screened. No intra- or postoperative complications were recorded. TAP+ patients required significantly less analgesia during the first 12 postoperative hours (P < 0.001). The patients with increased body mass index and large flap resected were more likely to fail the anesthetic block and required postoperative analgesia.
In aesthetic abdominal surgery, the TAP block is safe, is performed without ultrasound guidance, and markedly reduces the requirement of postoperative opioid analgesia. Future studies will now confirm these results and evaluate the consequences in terms of postoperative nausea, vomiting, and overall satisfaction of patients.
腹横肌平面（TAP）阻滞是一种局部区域麻醉技术，可阻滞位于腹横肌和腹内斜肌之间的感觉传入神经。我们描述了一项病例对照研究的结果，该研究比较了接受TAP阻滞的腹壁成形术患者与未接受该阻滞的类似患者组。
回顾病历，并根据是否存在TAP对患者进行分类。评估的结果是术后第一小时吗啡的需求量以及随后服用的氨酚双氢可待因片的数量。
筛查了75例患者。未记录到术中或术后并发症。TAP+患者在术后12小时内所需的镇痛药物明显较少（P < 0.001）。体重指数增加和切除大皮瓣的患者更有可能麻醉阻滞失败，需要术后镇痛。
在美容腹部手术中，TAP阻滞是安全的，无需超声引导即可进行，并且明显减少了术后阿片类药物镇痛的需求。未来的研究将证实这些结果，并评估对术后恶心、呕吐和患者总体满意度的影响。
