腹横肌平面阻滞:解剖与技术的最新综述。

Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques.

机构信息

Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.

Department of Anesthesiology, Kansai Medical University Hospital, Osaka, Japan.

出版信息

Biomed Res Int. 2017;2017:8284363. doi: 10.1155/2017/8284363. Epub 2017 Oct 31.

Abstract

PURPOSE OF REVIEW

Transversus abdominis plane (TAP) block is a regional technique for analgesia of the anterolateral abdominal wall. This review highlights the nomenclature system and recent advances in TAP block techniques and proposes directions for future research.

RECENT FINDINGS

Ultrasound guidance is now considered the gold standard in TAP blocks. It is easy to acquire ultrasound images; it can be used in many surgeries involving the anterolateral abdominal wall. However, the efficacy of ultrasound-guided TAP blocks is not consistent, which might be due to the use of different approaches. The choice of technique influences the involved area and block duration. To investigate the actual analgesic effects of TAP blocks, we unified the nomenclature system and clarified the definition of each technique. Although a single-shot TAP block is limited in duration, it is still the candidate of the analgesic standard for abdominal wall surgery because the use of the catheter technique and liposomal bupivacaine may overcome this limitation.

SUMMARY

Ultrasound-guided TAP blocks are commonly used. With the unified nomenclature and the development of catheter technique and/or liposomal local anesthetics, TAP blocks can be applied more appropriately to achieve better pain control.

摘要

目的综述

腹横肌平面(TAP)阻滞是一种用于前外侧腹壁镇痛的区域技术。本综述重点介绍了 TAP 阻滞技术的命名系统和最新进展,并为未来的研究提出了方向。

最近的发现

超声引导现在被认为是 TAP 阻滞的金标准。它易于获取超声图像,可以用于许多涉及前外侧腹壁的手术。然而,超声引导 TAP 阻滞的效果并不一致,这可能是由于使用了不同的方法。技术的选择会影响到涉及的区域和阻滞的持续时间。为了研究 TAP 阻滞的实际镇痛效果,我们统一了命名系统,并澄清了每种技术的定义。虽然单次 TAP 阻滞的持续时间有限,但它仍然是腹壁手术镇痛标准的候选者,因为导管技术和脂质体布比卡因的使用可能会克服这一限制。

总结

超声引导的 TAP 阻滞被广泛应用。随着命名系统的统一以及导管技术和/或脂质体局部麻醉剂的发展,TAP 阻滞可以更适当地应用,以实现更好的疼痛控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c691/5684553/d219f56e7679/BMRI2017-8284363.001.jpg

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