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输尿管冲击波碎石术期间单侧与双侧超声引导下腹横肌平面阻滞:一项前瞻性随机试验。

Unilateral versus bilateral ultrasound-guided transversus abdominis plane blocks during ureteric shock wave lithotripsy: A prospective randomized trial.

作者信息

Elnabtity Ali Mohamed Ali, Shabana Waleed Mansour

机构信息

Department of Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Department of Urology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

出版信息

Urol Ann. 2016 Jul-Sep;8(3):265-9. doi: 10.4103/0974-7796.184893.

Abstract

BACKGROUND

Ultrasound-guided transversus abdominis plane (TAP) block has been used for intra- and post-operative analgesia during abdominal operations and for ureteric shock wave lithotripsy (SWL) as well.

AIM

This study aimed at comparing ultrasound-guided unilateral versus bilateral TAP blocks as analgesic techniques for unilateral ureteric SWL.

SETTINGS AND DESIGN

Prospective randomized comparative study.

PATIENTS AND METHODS

Sixty patients scheduled for unilateral ureteric SWL were randomly allocated into two groups: Group (U) received unilateral TAP block in the form of 25 ml of bupivacaine 0.25% (i.e., 62.5 mg), and Group (B) received bilateral TAP blocks in the form of 25 ml of bupivacaine 0.25% (i.e., 62.5 mg) on each side.

STATISTICAL ANALYSIS

This was performed using SPSS program version 19 ((IBM Corp., Armonk, NY, USA) and EP 16 program.

RESULTS

The mean values of intra- and post-procedural visual analog scale at different time intervals were around (30), which was statistically insignificant between groups (P > 0.05). There were no significant differences between groups regarding cardiopulmonary stability, postanesthesia care unit time, the total amount of rescue fentanyl and patient satisfaction scores (P > 0.05). There were no significant side effects in both groups.

CONCLUSION

Ultrasound-guided unilateral TAP block is as safe and effective analgesic technique as bilateral TAP blocks during unilateral ureteric SWL. It can be used as the sole analgesic technique during ureteric SWL.

摘要

背景

超声引导下腹横肌平面(TAP)阻滞已用于腹部手术的术中及术后镇痛,也用于输尿管冲击波碎石术(SWL)。

目的

本研究旨在比较超声引导下单侧与双侧TAP阻滞作为单侧输尿管SWL镇痛技术的效果。

设置与设计

前瞻性随机对照研究。

患者与方法

60例计划行单侧输尿管SWL的患者被随机分为两组:U组接受单次25ml 0.25%布比卡因(即62.5mg)的单侧TAP阻滞,B组接受双侧TAP阻滞,每侧注射25ml 0.25%布比卡因(即62.5mg)。

统计分析

使用SPSS 19版程序(美国纽约州阿蒙克市IBM公司)和EP 16程序进行分析。

结果

不同时间点的术中及术后视觉模拟评分平均值约为(30),两组间差异无统计学意义(P>0.05)。两组在心肺稳定性、麻醉后监护病房停留时间、抢救用芬太尼总量及患者满意度评分方面差异均无统计学意义(P>0.05)。两组均无明显副作用。

结论

在单侧输尿管SWL中,超声引导下单侧TAP阻滞与双侧TAP阻滞一样是安全有效的镇痛技术。它可作为输尿管SWL期间的唯一镇痛技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4026/4944616/efe9f8ba3867/UA-8-265-g001.jpg

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