Kadam Rao V, Field J B
Department of anaesthesia, Statistical Consultant, The University of Adelaide, The Queen Elizabeth Hospital, Woodville, SA, Australia.
J Anaesthesiol Clin Pharmacol. 2011 Jul;27(3):333-6. doi: 10.4103/0970-9185.83676.
Transversus abdominis plane (TAP) block is a new regional analgesic technique for postoperative pain in abdominal surgery. Its efficacy is not clear, and thus it needs to be explored for its regular utilisation on prolonged period. The objective was to study the continuous local anaesthetic infusion effect on postoperative analgesia. Continuous use of TAP block as an analgesic technique has not been evaluated prospectively in clinical trials. This study evaluates the efficacy of ultrasound-guided TAP block in comparison with PCA fentanyl in major abdominal surgery.
There were 20 patients in the study, allocated to TAP and control groups. The parameters measured were pain scores on a numerical rating scale (NRS) of 0-10 at various time intervals and the amount of fentanyl used as rescue analgesia. Patient satisfaction scores were recorded in the TAP block group and along with any complications related to the block.
The postoperative median pain scores on coughing on day one were 6.0 for control group and 2.0 for the TAP group (P = 0.02); on day two, the equivalent scores were 7.0 and 2.0 (P = 0.01). The fentanyl requirement at one hour was 203 μ for the control group and 78 μg for the TAP group (P = 0.03); at day one, the control and TAP requirements were 1237 μg and 664 μg respectively (P = 0.01). Three TAP patients rated their satisfaction as 'excellent', four as 'satisfied, and two as 'poor'.
TAP block is a promising technique for postoperative analgesia in major abdominal surgeries. Our study demonstrated lower pain scores in the TAP group with reduced fentanyl requirement. Further, a large scale study is needed to establish the efficacy of TAP block in this setting.
腹横肌平面（TAP）阻滞是一种用于腹部手术术后疼痛的新型区域镇痛技术。其疗效尚不明确，因此需要探索其在较长时期内的常规应用。目的是研究局部麻醉药持续输注对术后镇痛的效果。作为一种镇痛技术，持续使用TAP阻滞尚未在临床试验中进行前瞻性评估。本研究评估了超声引导下TAP阻滞与PCA芬太尼在腹部大手术中的疗效。
本研究有20例患者，分为TAP组和对照组。测量的参数包括不同时间间隔的0-10数字评分量表（NRS）疼痛评分以及用作补救镇痛的芬太尼用量。记录TAP阻滞组的患者满意度评分以及与阻滞相关的任何并发症。
术后第一天咳嗽时的中位疼痛评分，对照组为6.0，TAP组为2.0（P = 0.02）；第二天，相应评分分别为7.0和2.0（P = 0.01）。对照组1小时时的芬太尼需求量为203μg，TAP组为78μg（P = 0.03）；第一天，对照组和TAP组的需求量分别为一千二百三十七μg和六百六十四μg（P = 0.01）。3例接受TAP阻滞的患者将其满意度评为“优秀”，4例评为“满意”，2例评为“差”。
TAP阻滞是腹部大手术术后镇痛的一种有前景的技术。我们的研究表明，TAP组疼痛评分较低，芬太尼需求量减少。此外，需要进行大规模研究以确定TAP阻滞在此情况下的疗效。
