超声引导下肋缘下腹横肌平面阻滞联合脂质体布比卡因与非脂质体布比卡因用于腹腔镜辅助供肾切术后的术后镇痛：一项前瞻性随机观察者盲法研究。
Ultrasound-guided subcostal transversus abdominis plane blocks with liposomal bupivacaine vs. non-liposomal bupivacaine for postoperative pain control after laparoscopic hand-assisted donor nephrectomy: a prospective randomised observer-blinded study.
机构信息
Department of Anaesthesiology, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
出版信息
Anaesthesia. 2016 Aug;71(8):930-7. doi: 10.1111/anae.13502. Epub 2016 May 30.
We compared the effect of subcostal transversus abdominis plane (TAP) block with liposomal bupivacaine to TAP block with non-liposomal bupivacaine on postoperative maximal pain scores in patients undergoing donor nephrectomy. Sixty patients were prospectively randomly assigned to receive ultrasound-guided bilateral TAPs with either 1.3% liposomal bupivacaine and normal saline or 0.25% non-liposomal bupivacaine with adrenaline. There was a significant decrease in maximal pain scores in the liposomal bupivacaine TAP group when compared with the non-liposomal bupivacaine group median (IQR [range]), 24-48 h after injection, 5 (3.0-5.2 [0-10]) vs. 6 (4.5-7.0 [1--9]) p = 0.009; 48-72 h after injection, 3 (2.0-5.0 [0-8]) vs. 5 (3.0-7.0 [0-10]) p = 0.02; and in opioid use 48-72 h after injection, mean (SD) μg equivalents of fentanyl 105 (97) vs. 182 (162) p = 0.03. Liposomal bupivacaine via subcostal TAP infiltration provided superior analgesia up to 72 h after injection when compared with non-liposomal bupivacaine.
我们比较了肋缘下腹横肌平面（TAP）阻滞联合脂质体布比卡因与 TAP 阻滞联合非脂质体布比卡因用于接受供肾切除术患者的术后最大疼痛评分的效果。60 名患者前瞻性随机分为两组，接受超声引导下双侧 TAP 阻滞，分别给予 1.3%脂质体布比卡因和生理盐水或 0.25%非脂质体布比卡因加肾上腺素。与非脂质体布比卡因组相比，脂质体布比卡因 TAP 组的最大疼痛评分在注射后 24-48 小时（中位数（IQR[范围]），5（3.0-5.2[0-10]）与 6（4.5-7.0[1-9]），p=0.009）、48-72 小时（3（2.0-5.0[0-8]）与 5（3.0-7.0[0-10]），p=0.02）和注射后 48-72 小时阿片类药物使用方面均显著降低，芬太尼等效用量（平均值（SD）μg ）分别为 105（97）与 182（162），p=0.03。与非脂质体布比卡因相比，肋缘下 TAP 内注射脂质体布比卡因在注射后 72 小时内提供了更好的镇痛效果。
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