Department of Anesthesiology, Baylor College of Medicine, Houston, TX 77030, USA.
Reg Anesth Pain Med. 2012 Mar-Apr;37(2):188-92. doi: 10.1097/AAP.0b013e318244851b.
Transversus abdominis plane (TAP) block has been shown to reduce pain and analgesic requirements after abdominal surgery. Our hypothesis was that bilateral TAP blocks decrease pain after laparoscopic cholecystectomy when compared with local anesthetic infiltration of trocar insertion sites.
Eighty patients undergoing laparoscopic cholecystectomy were randomized to receive either bilateral TAP blocks or local anesthetic infiltration of trocar insertion sites with ropivacaine 0.5%. Postoperative pain scores and analgesic use for the first 24 hrs were recorded.
Eighty patients were enrolled in the study. After exclusions, data were analyzed on 39 patients in group T (bilateral TAP block) and 35 patients in group I (infiltration). There was no statistically significant difference in pain scores on the numeric analog scale (0-10) between the groups at 4 hrs after surgery (P = 0.18) or during the 24 hrs after surgery (P = 0.23). The time interval from anesthesia start to surgery start was greater in group T than group I (48 vs 35 mins, P < 0.001). There was no significant difference found in analgesic use during the first 24 hrs after surgery.
Bilateral ultrasound-guided TAP block is equivalent to local anesthetic infiltration of trocar insertion sites for overall postoperative pain in a heterogeneous group of patients undergoing laparoscopic cholecystectomy.
腹横肌平面（TAP）阻滞已被证明可减少腹部手术后的疼痛和镇痛需求。我们的假设是，与经皮穿刺部位局部麻醉浸润相比，双侧 TAP 阻滞可减少腹腔镜胆囊切除术术后的疼痛。
80 例行腹腔镜胆囊切除术的患者被随机分为接受双侧 TAP 阻滞或经皮穿刺部位局部麻醉浸润罗哌卡因 0.5%的组。记录术后 24 小时内的疼痛评分和镇痛药使用情况。
80 例患者纳入本研究。排除后，39 例患者（T 组，双侧 TAP 阻滞）和 35 例患者（I 组，浸润组）的数据进行了分析。术后 4 小时（P = 0.18）或术后 24 小时（P = 0.23），两组间数字模拟评分（0-10）的疼痛评分无统计学差异。T 组从麻醉开始到手术开始的时间间隔大于 I 组（48 分钟比 35 分钟，P < 0.001）。术后 24 小时内镇痛药的使用无显著差异。
在接受腹腔镜胆囊切除术的异质患者中，双侧超声引导 TAP 阻滞与经皮穿刺部位局部麻醉浸润在总体术后疼痛方面相当。
