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经腹横肌平面(TAP)阻滞与安慰剂在开放性耻骨后前列腺切除术的镇痛效果比较:一项前瞻性、随机、双盲研究。

Comparison between the analgesic efficacy of transversus abdominis plane (TAP) block and placebo in open retropubic radical prostatectomy: a prospective, randomized, double-blinded study.

机构信息

Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

J Clin Anesth. 2013 Sep;25(6):459-65. doi: 10.1016/j.jclinane.2013.04.009. Epub 2013 Aug 17.

Abstract

STUDY OBJECTIVE

To compare the efficacy of ultrasound-guided tansversus abdominis plane (TAP) block with placebo for postoperative analgesia after retropubic radical prostatectomy (RRP).

DESIGN

Prospective, randomized, double-blinded study.

SETTING

Tertiary-care Veterans Affairs (VA) hospital.

PATIENTS

ASA physical status 1, 2, and 3 patients scheduled for RRP.

INTERVENTIONS

Patients were randomized to two groups: the TAP group and the control group. All patients underwent an ultrasound-guided TAP block procedure after induction of general anesthesia and received either local anesthetic (TAP group) or normal saline (control group).

MEASUREMENTS

Opioid use and verbal analog pain scores at 1, 6, 12, and 24 hours after surgery were recorded, as was the frequency of side effects. Times to ambulation and first oral intake also were recorded.

MAIN RESULTS

The TAP block group had lower pain scores and required less total opioid in the first 24 hours after surgery. Time to first oral intake and time to ambulation were similar between the two groups.

CONCLUSION

The TAP block has early benefits in postoperative analgesia after RRP.

摘要

研究目的

比较超声引导腹横肌平面(TAP)阻滞与安慰剂在耻骨后前列腺根治术(RRP)后用于术后镇痛的效果。

设计

前瞻性、随机、双盲研究。

地点

三级保健退伍军人事务部(VA)医院。

患者

ASA 身体状况 1、2 和 3 级患者,计划进行 RRP。

干预措施

患者随机分为两组:TAP 组和对照组。所有患者均在全身麻醉诱导后接受超声引导的 TAP 阻滞,并接受局部麻醉(TAP 组)或生理盐水(对照组)。

测量

记录术后 1、6、12 和 24 小时的阿片类药物使用情况和口述模拟疼痛评分,以及不良反应的发生频率。还记录了下床活动和首次口服摄入的时间。

主要结果

TAP 阻滞组在术后 24 小时内疼痛评分较低,需要的阿片类药物总量较少。两组首次口服摄入和下床活动的时间相似。

结论

TAP 阻滞在 RRP 后早期有术后镇痛的益处。

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