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改良胸腹神经阻滞用于小儿腹腔镜胆囊切除术后镇痛

The modified thoracoabdominal nerve block for post-operative analgesia in paediatric laparoscopic cholecystectomy.

作者信息

Ozen Volkan, Acik Mehmet Eren, Ozen Nurten

机构信息

Department of Anesthesiology and Reanimation, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.

Department of Anesthesiology and Reanimation, Demiroglu Bilim University, Istanbul, Turkey.

出版信息

J Minim Access Surg. 2024 Oct 1;20(4):452-455. doi: 10.4103/jmas.jmas_174_22. Epub 2023 May 10.

Abstract

The limited data on post-operative analgesia management after laparoscopic cholecystectomy in the paediatric population make it difficult for clinicians to manage pain in this group. Administration of a modified thoracoabdominal nerve block through a perichondrial approach (M-TAPA) has recently been identified as a technique providing effective analgesia on the anterior and lateral thoracoabdominal wall. Unlike thoracoabdominal nerve block through the perichondrial approach block, the local anaesthetic (LA) with M-TAPA block provides effective post-operative analgesia in abdominal surgery by affecting T5-T12 dermatomes, just like when applied to the lower part of the perichondrium. As far as we know, all patients in previous case reports were adults, and we did not come across any study on the effectiveness of M-TAPA in paediatric patients. We present our case who did not need any additional analgesic during the post-operative 24 h after an M-TAPA block was administered before paediatric laparoscopic cholecystectomy.

摘要

儿科人群腹腔镜胆囊切除术后镇痛管理的数据有限,这使得临床医生难以对该群体进行疼痛管理。最近,通过软骨膜途径实施改良胸腹神经阻滞(M-TAPA)被确定为一种在前胸腹壁提供有效镇痛的技术。与通过软骨膜途径阻滞胸腹神经不同,M-TAPA阻滞使用的局部麻醉剂通过影响T5-T12皮节在腹部手术中提供有效的术后镇痛,就像应用于软骨膜下部时一样。据我们所知,之前病例报告中的所有患者均为成年人,我们未找到任何关于M-TAPA在儿科患者中有效性的研究。我们报告了一例在小儿腹腔镜胆囊切除术前接受M-TAPA阻滞术后24小时内无需任何额外镇痛的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8ba/11601968/18da0cefb82b/JMAS-20-452-g001.jpg

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