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腹腔镜引导下腹横肌平面阻滞对腹腔镜 IPOM 加手术患者有效性的随机对照试验。

A randomized controlled trial on the effectiveness of laparoscopic-guided transversus abdominis plane block in patients undergoing laparoscopic IPOM plus.

机构信息

Department of Surgical Gastroenterology, Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India.

Department of Surgical Gastroenterology and Liver Transplant, Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India.

出版信息

Hernia. 2024 Aug;28(4):1257-1263. doi: 10.1007/s10029-024-03016-w. Epub 2024 Mar 23.

DOI:10.1007/s10029-024-03016-w
PMID:38520615
Abstract

INTRODUCTION

Ventral hernia repairs, particularly laparoscopic ventral hernia repair (LVHR), have become common procedures among general surgeons worldwide. Despite the benefits of LVHR, acute postoperative pain remains a significant concern. Transversus abdominis plane (TAP) blocks have been employed to alleviate postoperative pain in various laparoscopic procedures. This study aimed to assess the effectiveness of laparoscopic-guided TAP block in laparoscopic IPOM plus and its impact on postoperative pain and analgesic requirements.

MATERIALS AND METHODS

A randomized controlled trial was conducted at a tertiary care center in India involving 72 patients undergoing laparoscopic IPOM plus. Patients were randomized into two groups: Group I received laparoscopic-guided TAP block, while Group II received standard general anesthesia without TAP block. Pain scores were assessed at 6, 12, and 24 h postoperatively using the numerical rating scale. Postoperative analgesic requirements were also recorded.

RESULTS

Group I demonstrated significantly lower pain scores at 6 and 24 h postoperatively compared to Group II. The need for additional analgesics was significantly lower in Group I (13.8%) compared to Group II (72.2%). There were no significant differences in age, BMI, duration of surgery, or other demographic characteristics between the two groups.

CONCLUSION

The findings of this randomized controlled trial demonstrate the effectiveness of laparoscopic-guided TAP blocks in reducing postoperative pain and analgesic requirements after laparoscopic IPOM plus.

摘要

引言

腹疝修补术,特别是腹腔镜下腹膜前疝修补术(LVHR),已成为全球普通外科医生的常见手术。尽管 LVHR 有许多益处,但急性术后疼痛仍然是一个严重的问题。腹横肌平面(TAP)阻滞已被用于减轻各种腹腔镜手术的术后疼痛。本研究旨在评估腹腔镜引导 TAP 阻滞在腹腔镜 IPOM 加术中的有效性及其对术后疼痛和镇痛需求的影响。

材料与方法

这是在印度一家三级护理中心进行的一项随机对照试验,共纳入 72 例接受腹腔镜 IPOM 加手术的患者。患者被随机分为两组:组 I 接受腹腔镜引导 TAP 阻滞,组 II 接受标准全身麻醉而不进行 TAP 阻滞。术后 6、12 和 24 小时使用数字评分量表评估疼痛评分。还记录了术后镇痛需求。

结果

与组 II 相比,组 I 在术后 6 和 24 小时的疼痛评分显著降低。组 I 需要额外镇痛药物的比例(13.8%)明显低于组 II(72.2%)。两组患者在年龄、BMI、手术持续时间或其他人口统计学特征方面无显著差异。

结论

这项随机对照试验的结果表明,腹腔镜引导 TAP 阻滞可有效减轻腹腔镜 IPOM 加术后的疼痛和镇痛需求。

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Evaluation of Transversus Abdominis Plane (TAP) Block in Hernia Surgery: A Meta-analysis.腹横肌平面(TAP)阻滞在疝修补手术中的评估:一项荟萃分析。
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