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腹横肌平面(TAP)阻滞在开放性腹部手术患者术后疼痛管理中的应用:一例病例报告及文献综述

Use of Transversus Abdominis Plane (TAP) Blocks for Postoperative Pain Management in a Patient With an Open Abdomen: A Case Report and Review of Literature.

作者信息

Berhe Simon, Kraus Fabian, Hanifi Mohammed Tariq, Vlassakov Kamen, Stopfkuchen-Evans Matthias

机构信息

Department of Surgery, Columbia University Irving Medical Center, New York, USA.

Department of Obstetrics and Gynecology, Klinikum der Universität München, München, DEU.

出版信息

Cureus. 2021 Jan 16;13(1):e12739. doi: 10.7759/cureus.12739.

Abstract

In light of the superior analgesia and opioid sparing effects provided by transversus abdominis plane (TAP) blocks, numerous new techniques and applications have evolved. However, TAP blocks are still underutilized in the critical care setting, and PubMed‑listed reports on the relevance of TAP integrity for TAP block efficacy are lacking. Here, we report bilateral TAP blocks delivering quick, potent and durable pain relief to a patient with open abdomen (OA) after prior management with opioids and epidural anesthesia had failed. Extending TAP block application to OA patients even in the post‑operative setting might hence reduce opioid consumption and quicken reconvalescence.

摘要

鉴于腹横肌平面(TAP)阻滞具有卓越的镇痛效果和阿片类药物节省效应,众多新技术和应用不断涌现。然而,TAP阻滞在重症监护环境中的应用仍未得到充分利用,且缺乏在PubMed上列出的关于TAP完整性与TAP阻滞效果相关性的报告。在此,我们报告了双侧TAP阻滞为一名开放性腹部(OA)患者提供了快速、强效且持久的疼痛缓解,该患者此前使用阿片类药物和硬膜外麻醉进行治疗均告失败。因此,将TAP阻滞应用扩展至OA患者,即使是在术后环境中,也可能减少阿片类药物的使用并加速康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6673/7883565/1d4b39b97452/cureus-0013-00000012739-i01.jpg

相似文献

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Perioperative transversus abdominis plane (TAP) blocks for analgesia after abdominal surgery.
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本文引用的文献

1
Perioperative transversus abdominis plane (TAP) blocks for analgesia after abdominal surgery.
Cochrane Database Syst Rev. 2020 Apr 9;4(4):CD007705. doi: 10.1002/14651858.CD007705.pub3.
4
Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques.
Biomed Res Int. 2017;2017:8284363. doi: 10.1155/2017/8284363. Epub 2017 Oct 31.
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Ultrasound-guided truncal blocks: A new frontier in regional anaesthesia.
Indian J Anaesth. 2016 Oct;60(10):703-711. doi: 10.4103/0019-5049.191665.
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Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials.
Can J Anaesth. 2016 Oct;63(10):1184-1196. doi: 10.1007/s12630-016-0679-x. Epub 2016 Jun 15.
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Evolution of the transversus abdominis plane block and its role in postoperative analgesia.
Best Pract Res Clin Anaesthesiol. 2014 Jun;28(2):117-26. doi: 10.1016/j.bpa.2014.04.001. Epub 2014 May 9.
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Transversus abdominis plane (TAP) blocks-a review.
Surgeon. 2012 Dec;10(6):361-7. doi: 10.1016/j.surge.2012.07.005. Epub 2012 Sep 10.

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