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超声引导下腹横肌平面阻滞与骶管硬膜外阻滞用于脐下手术患儿术后镇痛的比较

Comparison of Ultrasound-Guided Transversus Abdominis Plane Block and Caudal Epidural Block for Pain Relief in Children Undergoing Infraumbilical Surgeries.

作者信息

Ganesh Bindu, Swain Sumita, Banerjee Swarna

机构信息

Department of anesthesiology, IMS and SUM Hospital, Bhubaneswar, Odisha, India.

出版信息

Anesth Essays Res. 2021 Apr-Jun;15(2):161-166. doi: 10.4103/aer.aer_37_21. Epub 2021 Nov 7.

Abstract

BACKGROUND

Caudal epidural block combined with general anesthesia remains a popular choice of anesthesia for both supraumbilical and infraumbilical surgeries. More recently transversus abdominis plane block performed under ultrasound guidance is being described as an effective technique for postoperative analgesia for lower abdominal surgeries. The present study aims to compare the efficacy of ultrasound -guided TAP block and caudal epidural for paediatric infraumbilical surgeries.

AIMS AND OBJECTIVES

To compare the duration and efficacy of postoperative pain relief between TAP block and caudal epidural block in children undergoing lower abdominal surgeries.

METHODS

Fifty children of age group 2-7 years undergoing lower abdominal surgeries were randomized to groups T and C. All patients were given general anesthesia as per standardized anesthesia protocol. Group T were given ultrasound guided TAP block with 0.5 ml.kg-1 of 0.2% Ropivacaine. Group C were given 1 ml.kg-1 of 0.2% ropivacaine as caudal block. All the children were assessed using FLACC scale. Their vitals, pain scores, duration of postoperative analgesia and requirement of supplemental analgesics were noted.

RESULTS

Rescue analgesic requirement was significantly less in Group T compared to Group C. Mean postoperative analgesia time was significantly more in Group T (342 mins) as compared to Group C (198 mins).

CONCLUSION

Ultrasound guided TAP block provides better postoperative analgesia after loer abdominal surgeries in children.

摘要

背景

骶管硬膜外阻滞联合全身麻醉仍是脐上和脐下手术常用的麻醉选择。最近,超声引导下的腹横肌平面阻滞被描述为一种用于下腹部手术术后镇痛的有效技术。本研究旨在比较超声引导下的腹横肌平面阻滞和骶管硬膜外阻滞用于小儿脐下手术的疗效。

目的

比较腹横肌平面阻滞和骶管硬膜外阻滞对下腹部手术患儿术后疼痛缓解的持续时间和疗效。

方法

将50例年龄在2至7岁接受下腹部手术的儿童随机分为T组和C组。所有患者均按照标准化麻醉方案给予全身麻醉。T组接受超声引导下的腹横肌平面阻滞,注射0.5 ml·kg-1的0.2%罗哌卡因。C组给予1 ml·kg-1的0.2%罗哌卡因进行骶管阻滞。所有儿童均使用面部表情、腿部活动、活动、哭闹、安慰(FLACC)量表进行评估。记录他们的生命体征、疼痛评分、术后镇痛持续时间和补充镇痛药的需求。

结果

与C组相比,T组的补救性镇痛需求显著减少。T组的平均术后镇痛时间(342分钟)明显长于C组(198分钟)。

结论

超声引导下的腹横肌平面阻滞为小儿下腹部手术后提供了更好的术后镇痛效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5530/8916125/a60e020b5e09/AER-15-161-g001.jpg

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