NEMA Research, Naples, Florida, USA.
Pain Pract. 2013 Apr;13(4):332-44. doi: 10.1111/j.1533-2500.2012.00595.x. Epub 2013 Feb 13.
Poorly controlled acute pain during the postoperative setting after abdominal surgery can be detrimental to the patient. Current pain management practices for the postoperative abdominal surgery patient rely heavily on opioids, which are associated with many unwanted side effects. Recently, interest surrounding regional anesthesia has been growing owing to its demonstrated efficacy and safety outcomes. More specifically, the transversus abdominis plane (TAP) block procedure has attracted attention owing to its ability to successfully block peripheral pain signaling in the abdomen, its ease of use, few complications, and its greater acceptability. A majority of the studies published has demonstrated the successful reduction in pain in many abdominal surgical procedures using local anesthetics during the TAP block. However, the short duration of the pain block causes the patient to still rely on other analgesics throughout the additional postoperative days. Preliminary studies using continuous infusion catheters placed in the TAP has been one of the ways to prolong the nerve block in the abdomen; however, technical and operational issues currently limit the widespread adoption of this method. In this review, current studies will be presented and summarized to update the field on the potential benefits of the TAP block procedure, in addition to providing insight into the future direction of the drugs that could be used for TAP block.
术后腹部手术后急性疼痛控制不佳可能对患者有害。目前，术后腹部手术患者的疼痛管理实践主要依赖于阿片类药物，但阿片类药物存在许多不良副作用。最近，由于区域麻醉具有良好的疗效和安全性，人们对其越来越感兴趣。具体来说，腹横肌平面（TAP）阻滞因其能够成功阻断腹部外周疼痛信号、易于操作、并发症少以及患者接受度更高而受到关注。大多数已发表的研究表明，在 TAP 阻滞中使用局部麻醉药可成功减轻许多腹部手术的疼痛。然而，疼痛阻滞的持续时间短，导致患者在术后的其他日子仍需依赖其他镇痛药。在 TAP 中放置连续输注导管是延长腹部神经阻滞的一种方法；然而，技术和操作问题目前限制了这种方法的广泛应用。在这篇综述中，将介绍和总结当前的研究，以更新 TAP 阻滞的潜在益处，并为 TAP 阻滞中可能使用的药物的未来发展方向提供参考。
