Sinha Aparna, Jayaraman Lakshmi, Punhani Dinesh, Chowbey Pradeep
Department of Anesthesiology, Institute of Minimal Access, Metabolic and Bariatric Surgery, Max Super Speciality Hospital, New Delhi, India.
Department of Perioperative Care, Institute of Minimal Access, Metabolic and Bariatric Surgery, Max Super Speciality Hospital, New Delhi, India.
J Minim Access Surg. 2018 Jul-Sep;14(3):197-201. doi: 10.4103/jmas.JMAS_138_17.
Transversus abdominis plane (TAP) block is now a well-established technique in post-operative analgesia for lower abdominal surgeries. We evaluated the effect of ultrasound-guided TAP block on recovery parameters in patients undergoing endoscopic repair of abdominal wall hernia.
Thirty adults were randomised to receive either ropivacaine with dexmedetomidine (TR) or saline (TP) in TAP block, before emergence from anaesthesia. The patients were assessed for pain relief, sedation, time to ambulate (TA), discharge readiness (DR), postoperative opioid requirement and any adverse events.
: The median visual analogue scale pain score of the study group (TR) and the control group (TP) showed a significant difference at all time points. TA was 5.3 ± 0.5 (TR) versus 7.4 ± 0.8 (TP), P< 0.001 and DR was 7.5 ± 0.9 (TR) versus 8.9 ± 0.6 (TP), P< 0.001 in hours. No adverse events were observed in any group.
This study demonstrates that TAP block is a feasible option for pain relief following endoscopic repair of abdominal wall hernias. It produces markedly improved pain scores and promotes early ambulation leading to greater patient satisfaction and earlier discharge.
腹横肌平面(TAP)阻滞现已成为下腹部手术术后镇痛的成熟技术。我们评估了超声引导下TAP阻滞对腹壁疝内镜修补术患者恢复参数的影响。
30名成年人在麻醉苏醒前被随机分配接受TAP阻滞,其中一组注射罗哌卡因与右美托咪定(TR组),另一组注射生理盐水(TP组)。对患者进行疼痛缓解、镇静程度、下床活动时间(TA)、出院准备情况(DR)、术后阿片类药物需求量及任何不良事件的评估。
研究组(TR组)和对照组(TP组)的视觉模拟评分疼痛中位数在所有时间点均有显著差异。TA方面,TR组为5.3±0.5小时,TP组为7.4±0.8小时,P<0.001;DR方面,TR组为7.5±0.9小时,TP组为8.9±0.6小时,P<0.001。两组均未观察到不良事件。
本研究表明,TAP阻滞是腹壁疝内镜修补术后缓解疼痛的可行选择。它能显著改善疼痛评分,促进早期下床活动,提高患者满意度并实现更早出院。