Henshaw Daryl S, Baker Matthew L, Weller Robert S, Reynolds Jon Wellington, Jaffe Jonathan Douglas
Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1009, United States.
Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1009, United States.
J Clin Anesth. 2016 Jun;31:182-8. doi: 10.1016/j.jclinane.2016.01.028. Epub 2016 Apr 16.
The primary goal of this study was to determine whether transversus abdominis plane (TAP) blocks were effective as the primary anesthetic technique for insertion and/or removal of peritoneal dialysis catheters.
This study is a descriptive case series investigation.
Operating rooms at a tertiary care academic medical center.
Twenty-four patients, American Society of Anesthesiologists (ASA) physical status 3 and 4, were included in this study.
Patients who had received a TAP block preoperatively for open surgical insertion or removal of a peritoneal dialysis catheter over a 26-month period with the intent of the block to serve as the primary anesthetic were included in this study.
Preoperative and intraoperative sedative medications and local anesthetic medications were analyzed. The primary outcome of the study was the ability of the TAP block to provide surgical anesthesia as determined by a lack of need to convert to general anesthesia (defined by placement of an airway device, use of volatile anesthetics, intraoperative propofol infusion dose equal to or greater than 100 μg kg(-1) min(-1)). Secondary outcomes included analysis of any complications from the higher concentrations of local anesthetics required for surgical block.
Of 24 patients, 21 underwent the procedure without conversion to general anesthesia as defined above. No complications related to local anesthetics were found.
Transversus abdominis plane blockade can be successful at serving as the primary anesthetic modality for the insertion and/or removal of a peritoneal dialysis catheter by open-surgical approach. There were no systemic toxic effects or other complications recorded.
本研究的主要目标是确定腹横肌平面（TAP）阻滞作为腹膜透析导管置入和/或拔除的主要麻醉技术是否有效。
本研究为描述性病例系列调查。
一所三级医疗学术医学中心的手术室。
本研究纳入了24例美国麻醉医师协会（ASA）身体状况为3级和4级的患者。
本研究纳入了在26个月期间接受术前TAP阻滞以进行腹膜透析导管开放手术置入或拔除且该阻滞作为主要麻醉方式的患者。
分析术前和术中的镇静药物及局部麻醉药物。研究的主要结局是根据无需转为全身麻醉（定义为放置气道装置、使用挥发性麻醉剂、术中丙泊酚输注剂量等于或大于100μg·kg⁻¹·min⁻¹）来确定TAP阻滞提供手术麻醉的能力。次要结局包括分析手术阻滞所需较高浓度局部麻醉药的任何并发症。
24例患者中，21例按上述定义未转为全身麻醉完成了手术。未发现与局部麻醉药相关的并发症。
腹横肌平面阻滞可成功作为开放手术方式进行腹膜透析导管置入和/或拔除的主要麻醉方式。未记录到全身毒性作用或其他并发症。
