Service d'anesthésie et de réanimation, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix Marseille Université, Marseille, France; Service de réanimation DRIS, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.
Service d'anesthésie et de réanimation, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix Marseille Université, Marseille, France.
Anaesth Crit Care Pain Med. 2016 Dec;35(6):401-406. doi: 10.1016/j.accpm.2016.02.006. Epub 2016 Jun 23.
Single shot transversus abdominis plane (TAP) block and continuous local anesthetic infiltration wound catheter (CLAIWC) decreased the morphine consumption after caesarean section. The aim of this study was to compare the analgesic efficacy of CLAIWC and ultrasound-guided TAP block.
Sixty patients undergoing caesarean section were prospectively randomized. After the caesarean section, the postoperative analgesia was randomized to either a CLAIWC localized below the fascia with an elastomeric pump for 48hours or a bilateral ultrasound-guided TAP block with injection of ropivacaine. Every patient had a morphine pump patient-controlled analgesia. The primary outcome was the morphine consumption during the first 48hours. Secondary outcomes were pain score levels, adverse effects of opioids, and patient satisfaction. Variables were collected during 48hours after the caesarean section.
Median cumulative 48-hour morphine consumption was 17 [8-51] mg in the TAP group versus 21 [7-34] mg in the CLAIWC group (P=0.3). We did not find a difference between the groups regarding pain, side effects and satisfaction scores.
As part of a multimodal analgesic regimen, there is no significant difference between the TAP block and CLAIWC for postoperative analgesia after a caesarean section.
单次腹横肌平面(TAP)阻滞和连续局部麻醉浸润伤口导管(CLAIWC)可减少剖宫产术后吗啡的消耗。本研究的目的是比较 CLAIWC 和超声引导 TAP 阻滞的镇痛效果。
前瞻性随机选择 60 例行剖宫产术的患者。剖宫产术后,将术后镇痛随机分为 48 小时内放置在筋膜下的弹性泵 CLAIWC 或双侧超声引导 TAP 阻滞,并注入罗哌卡因。每位患者均有吗啡泵自控镇痛。主要结局是 48 小时内吗啡的消耗量。次要结局是疼痛评分水平、阿片类药物的不良反应和患者满意度。在剖宫产术后 48 小时内收集变量。
TAP 组 48 小时内累积吗啡消耗量中位数为 17 [8-51]mg,CLAIWC 组为 21 [7-34]mg(P=0.3)。两组在疼痛、副作用和满意度评分方面无差异。
作为多模式镇痛方案的一部分,TAP 阻滞与 CLAIWC 在剖宫产术后的镇痛效果无显著差异。