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Protocol for a multicentre, prospective, observational cohort study of variation in practice in perioperative analgesic strategies in elective laparoscopic colorectal surgery: the LapCoGesic Study.一项关于择期腹腔镜结直肠手术围手术期镇痛策略实践差异的多中心、前瞻性、观察性队列研究方案:LapCoGesic研究
BMJ Open. 2016 Sep 6;6(9):e008810. doi: 10.1136/bmjopen-2015-008810.
2
A multicentre, prospective, observational cohort study of variation in practice in perioperative analgesia strategies in elective laparoscopic colorectal surgery (the LapCoGesic study).一项关于择期腹腔镜结直肠手术围手术期镇痛策略实践差异的多中心、前瞻性、观察性队列研究(LapCoGesic研究)。
Ann R Coll Surg Engl. 2020 Jan;102(1):28-35. doi: 10.1308/rcsann.2019.0091. Epub 2019 Jun 24.
3
Transversus abdominis plane block versus perioperative intravenous lidocaine versus patient-controlled intravenous morphine for postoperative pain control after laparoscopic colorectal surgery: study protocol for a prospective, randomized, double-blind controlled clinical trial.腹腔镜结直肠手术后腹横肌平面阻滞与围手术期静脉注射利多卡因及患者自控静脉注射吗啡用于术后疼痛控制的比较:一项前瞻性、随机、双盲对照临床试验的研究方案
Trials. 2014 Dec 4;15:476. doi: 10.1186/1745-6215-15-476.
4
Transversus abdominis plane (TAP) block versus thoracic epidural analgesia (TEA) in laparoscopic colon surgery in the ERAS program.腹横肌平面(TAP)阻滞与胸段硬膜外镇痛(TEA)在加速康复外科(ERAS)程序下腹腔镜结肠手术中的比较。
Surg Endosc. 2018 Jan;32(1):376-382. doi: 10.1007/s00464-017-5686-7. Epub 2017 Jul 1.
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Dis Colon Rectum. 2014 Nov;57(11):1290-7. doi: 10.1097/DCR.0000000000000211.
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Comparison of analgesic efficacy of four-quadrant transversus abdominis plane (TAP) block and continuous posterior TAP analgesia with epidural analgesia in patients undergoing laparoscopic colorectal surgery: an open-label, randomised, non-inferiority trial.四象限腹横肌平面(TAP)阻滞与连续后路 TAP 镇痛与硬膜外镇痛在腹腔镜结直肠手术患者中的镇痛效果比较:一项开放标签、随机、非劣效性试验。
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Transversus abdominis plane (TAP) block in laparoscopic colorectal surgery improves postoperative pain management: a meta-analysis.腹横肌平面(TAP)阻滞在腹腔镜结直肠手术中改善术后疼痛管理的效果:一项荟萃分析。
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引用本文的文献

1
A multicentre, prospective, observational cohort study of variation in practice in perioperative analgesia strategies in elective laparoscopic colorectal surgery (the LapCoGesic study).一项关于择期腹腔镜结直肠手术围手术期镇痛策略实践差异的多中心、前瞻性、观察性队列研究(LapCoGesic研究)。
Ann R Coll Surg Engl. 2020 Jan;102(1):28-35. doi: 10.1308/rcsann.2019.0091. Epub 2019 Jun 24.

本文引用的文献

1
Demonstrating the benefits of transversus abdominis plane blocks on patient outcomes in laparoscopic colorectal surgery: review of 200 consecutive cases.在腹腔镜结直肠手术中演示腹横肌平面阻滞对患者结局的益处:200 例连续病例回顾。
J Am Coll Surg. 2014 Dec;219(6):1143-8. doi: 10.1016/j.jamcollsurg.2014.08.011. Epub 2014 Sep 16.
2
Role of epidural and patient-controlled analgesia in site-specific laparoscopic colorectal surgery.硬膜外镇痛和患者自控镇痛在特定部位腹腔镜结直肠手术中的作用。
JSLS. 2014 Oct-Dec;18(4). doi: 10.4293/JSLS.2014.00207.
3
Enhancing the Enhanced Recovery Program in Colorectal Surgery - Use of Extended-Release Epidural Morphine (DepoDur®).加强结直肠手术中的加速康复计划——使用缓释硬膜外吗啡(DepoDur®)。
Ann Coloproctol. 2014 Aug;30(4):186-91. doi: 10.3393/ac.2014.30.4.186. Epub 2014 Aug 26.
4
Randomized clinical trial on epidural versus patient-controlled analgesia for laparoscopic colorectal surgery within an enhanced recovery pathway.硬膜外与患者自控镇痛在加速康复路径下用于腹腔镜结直肠手术的随机临床试验。
Ann Surg. 2015 Apr;261(4):648-53. doi: 10.1097/SLA.0000000000000838.
5
Association between colonic diverticulosis and prevalence of colorectal polyps.结肠憩室病与结肠直肠息肉患病率之间的关联。
Int J Colorectal Dis. 2014 Aug;29(8):947-51. doi: 10.1007/s00384-014-1908-9. Epub 2014 May 28.
6
Comparison of analgesic efficacy of four-quadrant transversus abdominis plane (TAP) block and continuous posterior TAP analgesia with epidural analgesia in patients undergoing laparoscopic colorectal surgery: an open-label, randomised, non-inferiority trial.四象限腹横肌平面(TAP)阻滞与连续后路 TAP 镇痛与硬膜外镇痛在腹腔镜结直肠手术患者中的镇痛效果比较:一项开放标签、随机、非劣效性试验。
Anaesthesia. 2014 Apr;69(4):348-55. doi: 10.1111/anae.12546.
7
Epidural analgesia in laparoscopic colorectal surgery: a nationwide analysis of use and outcomes.腹腔镜结直肠手术中的硬膜外镇痛:使用和结果的全国性分析。
JAMA Surg. 2014 Feb;149(2):130-6. doi: 10.1001/jamasurg.2013.3186.
8
A nationwide analysis of the use and outcomes of epidural analgesia in open colorectal surgery.一项全国范围内的分析,研究了硬膜外镇痛在开放式结直肠手术中的应用和结果。
J Gastrointest Surg. 2013 Jun;17(6):1130-7. doi: 10.1007/s11605-013-2195-4. Epub 2013 Apr 18.
9
A randomised controlled trial of the efficacy of ultrasound-guided transversus abdominis plane (TAP) block in laparoscopic colorectal surgery.一项关于超声引导腹横肌平面(TAP)阻滞在腹腔镜结直肠手术中疗效的随机对照试验。
Surg Endosc. 2013 Jul;27(7):2366-72. doi: 10.1007/s00464-013-2791-0. Epub 2013 Feb 7.
10
Transversus abdominis plane blocks and enhanced recovery pathways: making the 23-h hospital stay a realistic goal after laparoscopic colorectal surgery.腹横肌平面阻滞和加速康复途径:使腹腔镜结直肠手术后 23 小时住院成为现实目标。
Surg Endosc. 2013 Jul;27(7):2481-6. doi: 10.1007/s00464-012-2761-y. Epub 2013 Jan 26.

一项关于择期腹腔镜结直肠手术围手术期镇痛策略实践差异的多中心、前瞻性、观察性队列研究方案:LapCoGesic研究

Protocol for a multicentre, prospective, observational cohort study of variation in practice in perioperative analgesic strategies in elective laparoscopic colorectal surgery: the LapCoGesic Study.

作者信息

Burnell Phillippa, Coates Rachael, Dixon Steven, Grant Lucy, Gray Matthew, Griffiths Ben, Jones Mike, Madhavan Anantha, McCallum Iain, McClean Ross, Naru Karen, Newton Lydia, O'Loughlin Paul, Shaban Fadlo, Sukha Anisha, Somnath Sameer, Shumon Syed, Harji Deena

机构信息

Department of Academic Surgery, University of Newcastle, Newcastle upon Tyne, UK.

出版信息

BMJ Open. 2016 Sep 6;6(9):e008810. doi: 10.1136/bmjopen-2015-008810.

DOI:10.1136/bmjopen-2015-008810
PMID:27601484
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5020879/
Abstract

INTRODUCTION

Laparoscopic surgery combined with enhanced recovery programmes has become the gold standard in the elective management of colorectal disease. However, there is no consensus with regard to the optimal perioperative analgesic regime in this cohort of patients, with a number of options available, including thoracic epidural spinal analgesia, patient-controlled analgesia, subcutaneous and/or intraperitoneal local anaesthetics, local anaesthetic wound infiltration catheters and transversus abdominis plane blocks. This study aims to explore any differences in analgesic strategies employed across the North East of England and to assess whether any variation in practice has an impact on clinical outcomes.

METHODS AND ANALYSIS

All North East Colorectal units will be recruited for participation by the Northern Surgical Trainees Research Association (NoSTRA). Data will be collected over a consecutive 2-month period. Outcome measures will include postoperative pain score, postoperative opioid analgesic use and side effects, length of stay, 30-day complication rates, 30-day reoperative rates and 30-day readmission rates.

ETHICS AND DISSEMINATION

Ethical approval for this study has been granted by the National Research Ethics Service. The protocol will be disseminated through NoSTRA. Individual unit data will be presented at local meetings. Overall collective data will be published in peer-reviewed journals and presented at relevant surgical meetings.

摘要

引言

腹腔镜手术联合加速康复方案已成为结直肠疾病择期治疗的金标准。然而,对于这类患者的最佳围手术期镇痛方案尚无共识,有多种选择,包括胸段硬膜外脊髓镇痛、患者自控镇痛、皮下和/或腹腔内局部麻醉、局部麻醉伤口浸润导管和腹横肌平面阻滞。本研究旨在探讨英格兰东北部采用的镇痛策略的差异,并评估实践中的任何差异是否会对临床结果产生影响。

方法与分析

所有英格兰东北部的结直肠科室将由北方外科实习医生研究协会(NoSTRA)招募参与研究。数据将在连续2个月的时间内收集。结果指标将包括术后疼痛评分、术后阿片类镇痛药的使用及副作用、住院时间、30天并发症发生率、30天再次手术率和30天再入院率。

伦理与传播

本研究已获得国家研究伦理服务机构的伦理批准。该方案将通过NoSTRA进行传播。各科室的个体数据将在当地会议上展示。总体汇总数据将发表在同行评议期刊上,并在相关外科会议上展示。