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超声引导下腹横肌平面阻滞对腹股沟疝修补术患者术后镇痛的效果

Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair.

作者信息

Venkatraman Rajagopalan, Abhinaya Ranganathan Jothi, Sakthivel Ayyanar, Sivarajan Govindarajan

机构信息

Department of Anaesthesia, SRM Medical College Hospital, and Research Centre, Chennai, Tamil Nadu, India.

出版信息

Local Reg Anesth. 2016 Jan 18;9:7-12. doi: 10.2147/LRA.S93673. eCollection 2016.

Abstract

BACKGROUND AND AIM

Transversus abdominis plane block (TAP block) is a novel procedure to provide postoperative analgesia following inguinal hernia surgery. The utilization of ultrasound has greatly augmented the success rate of this block and additionally avoiding complications. The aim of our study was to gauge the analgesic efficacy of ultrasound-guided TAP block in patients undergoing unilateral inguinal hernia repair.

MATERIALS AND METHODS

Sixty patients scheduled for elective inguinal hernia repair were selected for the study. At the end of the surgical procedure, they were randomly divided into two groups. Ultrasound-guided TAP block was performed with 20 mL of ropivacaine 0.2% (group A) or normal saline (group B). Visual analog scale (VAS) scores were used to assess pain. Paracetamol was given if VAS > 3 and tramadol was used when VAS > 6. Patients were monitored for VAS scores and total analgesic consumption for the 24-hour period.

RESULTS

The TAP block with ropivacaine (group A) reduced VAS scores at 4, 6, and 12 hours. There was no distinction in VAS scores at 0, 2, and 24 hours between the two groups. The duration of analgesia for TAP block with ropivacaine lasted for 390 minutes. Total analgesics consumption was also significantly reduced in group A than group B. No complication was reported to TAP block in both the groups.

CONCLUSION

The ultrasound-guided TAP block provides good postoperative analgesia, reduces analgesic requirements, and provides good VAS scores with fewer complications following inguinal hernia surgery.

摘要

背景与目的

腹横肌平面阻滞(TAP阻滞)是一种为腹股沟疝修补术后提供镇痛的新方法。超声的应用极大地提高了该阻滞的成功率,并避免了并发症。我们研究的目的是评估超声引导下TAP阻滞在单侧腹股沟疝修补患者中的镇痛效果。

材料与方法

选取60例择期腹股沟疝修补患者进行研究。手术结束时,将他们随机分为两组。用20毫升0.2%罗哌卡因(A组)或生理盐水(B组)进行超声引导下TAP阻滞。采用视觉模拟评分法(VAS)评估疼痛程度。VAS>3时给予对乙酰氨基酚,VAS>6时使用曲马多。监测患者24小时内的VAS评分和总镇痛药物消耗量。

结果

罗哌卡因TAP阻滞(A组)在4、6和12小时降低了VAS评分。两组在0、2和24小时的VAS评分无差异。罗哌卡因TAP阻滞的镇痛持续时间为390分钟。A组的总镇痛药物消耗量也显著低于B组。两组均未报告TAP阻滞的并发症。

结论

超声引导下TAP阻滞可提供良好的术后镇痛,减少镇痛药物需求,在腹股沟疝修补术后具有良好的VAS评分且并发症较少。

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