Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Korean J Anesthesiol. 2011 Nov;61(5):413-8. doi: 10.4097/kjae.2011.61.5.413. Epub 2011 Nov 23.
The transversus abdominis plane block is recently described peripheral block to providing analgesia to the anterior abdominal wall. The goal of this study is to evaluate the analgesic efficacy of the ultrasound-guided transversus abdominis plane block (US-TAP block) in patients undergoing gynecologic surgery via a transverse lower abdominal skin incision.
Thirty-two patients undergoing gynecologic surgery were randomized to undergo standard care such as PCA, or to receive additional US-TAP block with standard care. After general anesthesia induction, a bilateral US-TAP block was performed using 0.375% ropivacaine 20 ml on each side. Postoperative demand of rescue analgesics in PACU and ward were recorded. Each patient was assessed postoperatively by a blinded investigator in the postanesthesia care unit (PACU) and at 2, 6, 10, 24, 48 hr postoperatively to investigate pain, drowsiness, nausea and itch.
The US-TAP block reduced pain intensity compared to standard care in the PACU (5.2 ± 3.1 vs 8.4 ± 1.3) and at 2, 24 postoperative hours (3.0 ± 2.4 vs 5.2 ± 2.4, 0.9 ± 1.5 vs 2.2 ± 1.9). Fentanyl requirements in PACU was reduced (20.3 ± 20.9 vs 62.5 ± 35.4 µg, P < 0.05). In ward, pethidine requirements was reduced (21.9 ± 28.7 vs 56.3 ± 34.8 mg, P < 0.05).
The US-TAP block with standard care provide more effective analgesia after gynecologic surgery via a transverse lower abdominal skin incision.
腹横肌平面阻滞是一种新的外周神经阻滞方法，可提供前腹壁的镇痛。本研究的目的是评估超声引导下腹横肌平面阻滞（US-TAP 阻滞）在经下腹部横向皮肤切口行妇科手术患者中的镇痛效果。
32 例行妇科手术的患者随机分为标准治疗组（接受 PCA）或标准治疗加双侧 US-TAP 阻滞组（接受双侧 US-TAP 阻滞，每侧用 0.375%罗哌卡因 20ml）。全身麻醉诱导后行双侧 US-TAP 阻滞。术后在 PACU 和病房记录补救性镇痛药物的需求。术后由麻醉后恢复室（PACU）和术后 2、6、10、24、48 小时的盲法观察者评估患者的疼痛、嗜睡、恶心和瘙痒情况。
与标准治疗相比，US-TAP 阻滞在 PACU（5.2±3.1 vs 8.4±1.3）和术后 2、24 小时（3.0±2.4 vs 5.2±2.4，0.9±1.5 vs 2.2±1.9）时疼痛强度降低。在 PACU 时芬太尼的需求减少（20.3±20.9 vs 62.5±35.4µg，P<0.05）。在病房时哌替啶的需求减少（21.9±28.7 vs 56.3±34.8mg，P<0.05）。
经下腹部横向皮肤切口行妇科手术后，US-TAP 阻滞联合标准治疗可提供更有效的镇痛。
