Mitchell Anja Ulrike, Torup Henrik, Hansen Egon G, Petersen Pernille Lykke, Mathiesen Ole, Dahl Jørgen B, Rosenberg Jacob, Møller Ann Merete
Department of Anaesthesiology, Herlev Hospital.
Dan Med J. 2012 Mar;59(3):A4404.
INTRODUCTION: The ultrasound-guided transversus abdominis plane (TAP) block is used to treat postoperative pain after abdominal surgery. Abdominal wall sensory nerves are anaesthetised by injecting local anaesthetics into the neurofascial plane between the internal oblique and the transversus abdominis muscles. Sensory assessment of a TAP block may guide the decision on the extent of the block. The purpose of this study was to investigate if the dermatomal extent of sensory blockade after injection of 20 ml 0.5% ropivacaine bilaterally into the TAP can be assessed using cold and pinprick sensation. MATERIAL AND METHODS: Subcostal TAP block was performed bilaterally in 20 awake patients scheduled for elective abdominal surgery. Sensory change in dermatomes T4-L4 was tested with pinprick using a blunt needle and cold disinfectant swabs after 10, 20 and 30 minutes. RESULTS: Data from 20 patients (40 blocks) were analysed. Eighteen patients registered sensory change after subcostal TAP block, and dermatomes T10-T12 were blocked after 30 minutes in all of these patients. Spread of sensory change to dermatomes T5-L3 was variable. CONCLUSION: This study confirmed that the dermatomal extent of a sensory blockade after a single-shot subcostal TAP block can be assessed using cold and pinprick sensation. FUNDING: not relevant. TRIAL REGISTRATION: The study was registered at clinicaltrials.gov with the registration number NCT01024868.
引言:超声引导下腹横肌平面(TAP)阻滞用于治疗腹部手术后的疼痛。通过将局部麻醉药注射到腹内斜肌和腹横肌之间的神经筋膜平面来麻醉腹壁感觉神经。TAP阻滞的感觉评估可指导关于阻滞范围的决策。本研究的目的是调查双侧向TAP注射20 ml 0.5%罗哌卡因后,是否可以使用冷觉和针刺觉来评估感觉阻滞的皮节范围。 材料与方法:对20例计划进行择期腹部手术的清醒患者双侧进行肋下TAP阻滞。在10、20和30分钟后,使用钝针和冷消毒棉签通过针刺测试T4-L4皮节的感觉变化。 结果:分析了20例患者(40次阻滞)的数据。18例患者在肋下TAP阻滞后记录到感觉变化,所有这些患者在30分钟后T10-T12皮节被阻滞。感觉变化扩散到T5-L3皮节的情况各不相同。 结论:本研究证实,单次肋下TAP阻滞后的感觉阻滞皮节范围可以使用冷觉和针刺觉进行评估。 资金:不相关。 试验注册:该研究在clinicaltrials.gov上注册,注册号为NCT01024868。
Anaesth Intensive Care. 2011-3
Can J Anaesth. 2011-7-12
Anesth Pain Med. 2017-10-20
BMC Anesthesiol. 2018-4-10