Kokulu Serdar, Bakı Elif Doğan, Kaçar Emre, Bal Ahmet, Şenay Hasan, Üstün Kübra Demir, Yılmaz Sezgin, Ela Yüksel, Sıvacı Remziye Gül
Department of Anesthesiology and Reanimation, Afyon Kocatepe University, School of Medicine, Afyonkarahisar, Turkey.
Department of Radiology, Afyon Kocatepe University, School of Medicine, Afyonkarahisar, Turkey.
Med Sci Monit. 2014 Dec 23;20:2783-7. doi: 10.12659/MSM.892055.
Use of transversus abdominis plane (TAP) block for postoperative analgesia is continuously increasing. However, few studies have investigated intraoperative effects of TAP block. We aimed to study the effects of TAP block in terms of cost-effectiveness and consumption of inhalation agents.
Forty patients undergoing laparoscopic cholecystectomy were enrolled in this study. Patients were randomly divided into 2 groups: Group 1 (n=20) patients received TAP block and Group 2 (n=20) patients did not receive TAP block. Standard anesthesia induction was used in all patients. For the maintenance of anesthesia, fractional inspired oxygen (FIO2) of 50% in air with desflurane was used with a fresh gas flow of 4 L/min. All patients were monitored with electrocardiography and for peripheral oxygen saturation (SpO2), end-tidal carbon dioxide (ET), heart rate (HR), noninvasive mean blood pressure (MBP), and bispectral index (BIS). Bilateral TAP blocks were performed under ultrasound guidance to Group 1 patients. The BIS value was maintained at between 40 and 50 during the surgery. The Dion formula was used to calculate consumption of desflurane for each patient.
There was no difference between the groups with respect to demographic characteristics of the patients. Duration of anesthesia, surgery time, and dosage of fentanyl were similar in the 2 groups. However, the cost and consumption of desflurane was significantly lower in Group 1.
Total anesthesia consumption was lower and the cost-effectiveness of anesthesia was better in TAP block patients with general anesthesia than in non-TAP block patients undergoing laparoscopic cholecystectomy.
腹横肌平面（TAP）阻滞用于术后镇痛的应用正在持续增加。然而，很少有研究调查TAP阻滞的术中效果。我们旨在研究TAP阻滞在成本效益和吸入麻醉剂消耗方面的效果。
本研究纳入了40例行腹腔镜胆囊切除术的患者。患者被随机分为2组：第1组（n = 20）患者接受TAP阻滞，第2组（n = 20）患者未接受TAP阻滞。所有患者均采用标准麻醉诱导。维持麻醉时，使用50%的吸入氧分数（FIO2）与地氟烷混合，新鲜气流量为4 L/min。所有患者均进行心电图监测以及外周血氧饱和度（SpO2）、呼气末二氧化碳（ET）、心率（HR）、无创平均血压（MBP）和脑电双频指数（BIS）监测。在超声引导下对第1组患者进行双侧TAP阻滞。手术期间BIS值维持在40至50之间。使用迪翁公式计算每位患者的地氟烷消耗量。
两组患者的人口统计学特征无差异。两组的麻醉持续时间、手术时间和芬太尼用量相似。然而，第1组的地氟烷成本和消耗量显著更低。
与未接受TAP阻滞的腹腔镜胆囊切除术患者相比，接受全身麻醉的TAP阻滞患者的总麻醉消耗量更低，麻醉的成本效益更好。
