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超声引导下肋下腹横肌平面阻滞与腰方肌阻滞在腹腔镜胆囊切除术中的比较:一项前瞻性、随机、对照临床研究

Comparison of Ultrasound-Guided Subcostal Transversus Abdominis Plane Block and Quadratus Lumborum Block in Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Clinical Study.

作者信息

Baytar Çağdaş, Yılmaz Canan, Karasu Derya, Topal Serra

机构信息

Erciş State Hospital, Department of Anesthesiology and Reanimation, Van, Turkey.

Health Sciences University, Bursa Yüksek Ihtisas Training and Education Hospital, Department of Anesthesiology and Reanimation, Bursa, Turkey.

出版信息

Pain Res Manag. 2019 Feb 3;2019:2815301. doi: 10.1155/2019/2815301. eCollection 2019.

DOI:10.1155/2019/2815301
PMID:30863471
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6377967/
Abstract

BACKGROUND

The aim of this study was to compare the effectiveness of ultrasound-guided (USG) subcostal transversus abdominis plane (TAP) block and quadratus lumborum (QL) block as preventive analgesia methods after laparoscopic cholecystectomy.

METHODS

A total of 120 patients, 18-75 years of age, were separated into 2 groups preoperatively. Patients in group TAP ( = 60) received 0.3 ml/kg bupivacaine with USG bilateral subcostal TAP block; patients in group QL ( = 60) received 0.3 ml/kg bupivacaine with USG bilateral QL block. Patients were assessed 24 h postoperatively, and pain scores, time to first analgesia requirement, total analgesia dose, and postoperative complications during the first 24 h were recorded.

RESULTS

Fifty-three patients in group TAP and 54 in group QL were ultimately evaluated. No statistically significant difference was found in at rest and dynamic visual analog scale scores between the groups. There was also no statistically significant difference between the groups with regard to total analgesia consumption. Although the duration of anesthesia was significantly longer in group QL, no statistically significant difference was found in the duration of surgery between the groups ( < 0.05).

CONCLUSIONS

Results of this study demonstrated that USG subcostal TAP and QL blocks similarly reduced postoperative pain scores and analgesia consumption, with high patient satisfaction. However, subcostal TAP block could be considered preferable to QL block because it can be applied easily and in a shorter time.

摘要

背景

本研究旨在比较超声引导下肋下腹横肌平面(TAP)阻滞和腰方肌(QL)阻滞作为腹腔镜胆囊切除术后预防性镇痛方法的有效性。

方法

总共120例年龄在18至75岁之间的患者在术前被分为两组。TAP组(n = 60)患者接受超声引导下双侧肋下TAP阻滞,给予0.3 ml/kg布比卡因;QL组(n = 60)患者接受超声引导下双侧QL阻滞,给予0.3 ml/kg布比卡因。术后24小时对患者进行评估,记录疼痛评分、首次需要镇痛的时间、总镇痛剂量以及术后24小时内的术后并发症。

结果

最终对TAP组的53例患者和QL组的54例患者进行了评估。两组之间在静息和动态视觉模拟量表评分上未发现统计学上的显著差异。两组之间在总镇痛消耗量方面也未发现统计学上的显著差异。尽管QL组的麻醉持续时间明显更长,但两组之间的手术持续时间未发现统计学上的显著差异(P < 0.05)。

结论

本研究结果表明,超声引导下肋下TAP阻滞和QL阻滞在降低术后疼痛评分和镇痛消耗量方面效果相似,患者满意度高。然而,肋下TAP阻滞可能比QL阻滞更可取,因为它应用简便且耗时更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ede0/6377967/d9d481fec75f/PRM2019-2815301.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ede0/6377967/d9d481fec75f/PRM2019-2815301.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ede0/6377967/d9d481fec75f/PRM2019-2815301.001.jpg

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