Bojaxhi Elird, Clendenen Steven R
Anesthesiology, Mayo Clinic, Jacksonville, USA.
Cureus. 2019 Sep 16;11(9):e5664. doi: 10.7759/cureus.5664.
Integrating regional anesthesia and multi-modal pain management is a well described and successful strategy to reduce post-operative pain. The use of transversus abdominis plane (TAP) blocks has been well-described for abdominal surgery, which includes various injection sites to improve analgesic coverage and catheter usage to prolong duration of analgesia. After a cadaver contrast study, our investigation illustrates that, for a TAP catheter block, a programmed intermittent bolus provides greater spread of the injection in the fascial plane as compared to a continuous infusion. Clinical trials are needed to investigate if these findings translate to greater analgesic coverage of the anterior abdominal wall, particularly in the subcostal region.
整合区域麻醉和多模式疼痛管理是一种已被充分描述且成功的减轻术后疼痛的策略。腹横肌平面（TAP）阻滞在腹部手术中的应用已得到充分描述，其中包括各种注射部位以改善镇痛覆盖范围以及使用导管来延长镇痛持续时间。经过一项尸体对照研究，我们的调查表明，对于TAP导管阻滞，与持续输注相比，程序性间歇性推注在筋膜平面内可使注射药物扩散得更广。需要进行临床试验来研究这些发现是否能转化为对腹前壁，尤其是肋下区域更大的镇痛覆盖范围。
