University of Kentucky, Lexington, KY, United States.
Albany Medical Center, Albany, NY, United States.
Am J Surg. 2018 Apr;215(4):643-646. doi: 10.1016/j.amjsurg.2017.09.006. Epub 2017 Sep 20.
Postoperative pain management is a major contributor to recovery and discharge in bariatric surgery. Local anesthetic agents are of particular interest: they're non-sedating and may reduce postoperative pain and hospital length of stay (LOS).
Researchers queried the Bariatric Surgery Service Database for patients undergoing laparoscopic weight loss surgery from January 2012-December 2014. Patients were divided between those who did and did not receive liposomal bupivacaine intra-operatively. Measures included demographics, narcotic use, LOS, antiemetic use, and pain scales.
The liposomal group consisted of 233 patients and the PCA group consisted of 243 patients. The liposomal group had significantly less narcotic use than the PCA group in terms of IV morphine equivalents. This did not translate into a reduction in LOS in the liposomal group.
TAP block using liposomal bupivacaine provides effective analgesia comparable to PCA.
术后疼痛管理是减重手术恢复和出院的主要因素。局部麻醉剂尤其受到关注：它们无镇静作用，可能会减轻术后疼痛和住院时间（LOS）。
研究人员查询了腹腔镜减重手术服务数据库，以了解 2012 年 1 月至 2014 年 12 月接受手术的患者。患者分为术中接受和未接受脂质体布比卡因的两组。措施包括人口统计学，阿片类药物使用， LOS，止吐药使用和疼痛量表。
脂质体组有 233 例患者，PCA 组有 243 例患者。在 IV 吗啡当量方面，脂质体组的阿片类药物使用量明显少于 PCA 组。这并没有转化为脂质体组 LOS 的减少。
TAP 阻滞使用脂质体布比卡因提供了与 PCA 相当的有效镇痛作用。
