Department of Anaesthesia, Raigmore Hospital, Inverness IV2 3UJ, UK.
Int J Surg. 2013;11(9):792-4. doi: 10.1016/j.ijsu.2013.05.039. Epub 2013 Jun 11.
A best evidence topic was written according to a structured protocol. The question addressed whether local anaesthetic infiltration of the transversus abdominis plane (TAP block) during a laparoscopic cholecystectomy improves pain control. Ten papers were found using the reported search, of which four represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group, study type, relevant outcomes and key results of these papers were tabulated. Three of the randomised controlled trials demonstrated a reduction in analgesic requirements associated with TAP blocks following laparoscopic cholecystectomy as compared to placebo. The remaining randomised study compared TAP blocks with local anaesthetic infiltration of laparoscopic port sites and showed no significant difference in clinical outcomes between these two techniques. We conclude that there is good evidence that TAP block in laparoscopic cholecystectomy leads to a reduction in pain scores and analgesic requirement, however there is no significant difference when compared to local anaesthetic infiltration of trocar insertion sites.
一个最佳证据主题是根据结构化方案编写的。该问题涉及到在腹腔镜胆囊切除术中局部麻醉浸润腹横肌平面（TAP 阻滞）是否可以改善疼痛控制。使用报告的搜索方法找到了 10 篇论文，其中 4 篇代表了回答临床问题的最佳证据。这些论文的作者、期刊、日期和出版国家、患者群体、研究类型、相关结果和关键结果都被制成了表格。三项随机对照试验表明，与安慰剂相比，TAP 阻滞可降低腹腔镜胆囊切除术后的镇痛需求。剩下的一项随机研究比较了 TAP 阻滞与腹腔镜穿刺部位局部麻醉浸润，两种技术在临床结果方面没有显著差异。我们的结论是，有很好的证据表明，TAP 阻滞在腹腔镜胆囊切除术中可降低疼痛评分和镇痛需求，但与套管插入部位局部麻醉浸润相比，没有显著差异。
