Niraj G, Kelkar Aditi, Hart Elaine, Kaushik Vipul, Fleet Danny, Jameson John
Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
Department of Anaesthesia and Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
J Clin Anesth. 2015 Nov;27(7):579-84. doi: 10.1016/j.jclinane.2015.07.005. Epub 2015 Aug 28.
Transversus abdominis plane (TAP) blocks have been reported to be an effective method of providing analgesia after abdominal surgery. To perform a prospective audit on the effectiveness of a novel technique of providing continuous transversus abdominis plane (TAP) analgesia in patients undergoing emergency and elective abdominal surgery.
Prospective single center audit over a 3-year period.
University hospital.
One hundred twenty-four American Society of Anesthesiologists I to IV adult patients presenting for elective as well as emergency abdominal surgery in whom epidural analgesia was contraindicated or refused.
Four quadrant TAP blocks and continuous TAP analgesia.
Numerical rating scale pain scores at rest and on coughing, nausea scores, satisfaction scores, complications, frequency of analgesia failure, therapeutic failure with continuous TAP analgesia and opioid consumption.
One hundred twenty-four patients who received continuous TAP analgesia were audited. This included 34 patients for elective open surgery, 36 patients for emergency laparotomy, and 54 patients who underwent elective laparoscopic colorectal surgery. Surgical incision was within the dermatomal limit of the block in 70% of the patients (88/124). Therapeutic failure with the technique was 10%. Frequency of analgesic failure over the 48-hour period was none in 39% and below 5 episodes in 57%.
Four quadrant transversus abdominis plane blocks and continuous TAP analgesia is an effective technique for providing postoperative analgesia after abdominal surgery. It has the potential to be used as a sole analgesic technique when the surgical incision is within its dermatomal limit.
据报道，腹横肌平面（TAP）阻滞是腹部手术后提供镇痛的有效方法。对一种为接受急诊和择期腹部手术的患者提供持续腹横肌平面（TAP）镇痛的新技术的有效性进行前瞻性审计。
为期3年的前瞻性单中心审计。
大学医院。
124例美国麻醉医师协会I至IV级成年患者，因择期和急诊腹部手术就诊，硬膜外镇痛被视为禁忌或被拒绝。
四象限TAP阻滞和持续TAP镇痛。
静息和咳嗽时的数字评分量表疼痛评分、恶心评分、满意度评分、并发症、镇痛失败频率、持续TAP镇痛的治疗失败情况及阿片类药物消耗量。
对124例接受持续TAP镇痛的患者进行了审计。其中包括34例择期开放手术患者、36例急诊剖腹手术患者和54例择期腹腔镜结直肠手术患者。70%的患者（88/124）手术切口在阻滞的皮节范围内。该技术的治疗失败率为10%。在48小时内，39%的患者无镇痛失败情况，57%的患者镇痛失败次数低于5次。
四象限腹横肌平面阻滞和持续TAP镇痛是腹部手术后提供术后镇痛的有效技术。当手术切口在其皮节范围内时，它有可能用作唯一的镇痛技术。
