Department of Anesthesiology, Otemae Hospital, Osaka, Japan.
Department of Anesthesiology, Nara Medical University, Nara, Japan.
Asian J Endosc Surg. 2023 Jul;16(3):648-652. doi: 10.1111/ases.13183. Epub 2023 Mar 23.
Modified thoracoabdominal nerves block through the perichondral approach (M-TAPA) was recently reported to provide broad analgesia with only a single injection of local anesthetics (LA) on each side. However, the effectiveness of M-TAPA in laparoscopic cholecystectomy (LC) is not often reported. We retrospectively evaluated the analgesic efficacy of M-TAPA in patients who underwent LC and compared it with conventional LA infiltration (LAI) by calculating the propensity score. The primary outcome was the frequency of analgesic use after surgery. Although there was no difference in the frequency of analgesic use within 48 hours (P = .063), there was significantly less analgesic use 24-48 hours after surgery in the TAPA group (P = .02). Intraoperative remifentanil administration also significantly decreased in the TAPA group (P < .001). We found that pre-incisional M-TAPA may have an advantage over LAI with respect to analgesia on postoperative day 1.
经软骨膜入路改良胸腹神经阻滞（M-TAPA）最近被报道，只需在每侧单次注射局部麻醉剂（LA），即可提供广泛的镇痛效果。然而，M-TAPA 在腹腔镜胆囊切除术（LC）中的有效性并不常被报道。我们通过计算倾向评分，回顾性评估了 M-TAPA 在接受 LC 手术的患者中的镇痛效果，并与传统的 LA 浸润（LAI）进行了比较。主要结果是手术后使用镇痛药的频率。尽管在 48 小时内使用镇痛药的频率没有差异（P=0.063），但在 TAPA 组中，术后 24-48 小时使用镇痛药的频率明显较低（P=0.02）。TAPA 组术中瑞芬太尼的给药也明显减少（P<0.001）。我们发现，与 LAI 相比，M-TAPA 可能在术后第一天的镇痛方面具有优势。
