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单侧肋间外筋膜平面阻滞与肋缘下 TAP 阻滞在腹腔镜胆囊切除术中的疗效比较:随机前瞻性研究。

Efficacy of Unilateral External Oblique Intercostal Fascial Plane Block Versus Subcostal TAP Block in Laparoscopic Cholecystectomy: Randomized, Prospective Study.

机构信息

Department of Anesthesiology and Reanimation, Hatay Mustafa Kemal University, Tayfur Ata Sökmen Medical Faculty, Hatay, Türkiye.

Department of Anesthesiology and Reanimation, Atatürk University, Medical Faculty, Erzurum, Türkiye.

出版信息

Surg Innov. 2024 Aug;31(4):381-388. doi: 10.1177/15533506241256529. Epub 2024 May 23.

Abstract

BACKGROUND

This study aimed to evaluate the effectiveness of unilateral external oblique intercostal nerve block (EOIB) in laparoscopic cholecystectomy surgery.

MATERIAL AND METHODS

After ethics committee approval, ASA I-II patients aged 18-70 who would undergo laparoscopic cholecystectomy surgery were included in the study. The patients were divided into two groups, external oblique intercostal nerve block (Group EOIB) and oblique subcostal transversus abdominis plane block (Group OSTAP). After surgery, EOIB or OSTAP block was administered with 20 mL of .25% bupivacaine then routine analgesia protocol was applied with iv paracetamol, and tramadol. Visual analog scale (VAS) scores and patient-controlled analgesia (PCA) consumption were monitored 24 hours after the operation. It was administered 25 mg pethidine as a rescue analgesic to patients with VAS ≥4.

RESULTS

Thirty six patients for Group EOIB and thirty four patients for Group OSTAP were included in the study. Lower VAS scores were observed in all groups. When PCA consumption, side effects, rescue analgesia consumption, and patient satisfaction were evaluated, there was no statistically significant difference between the groups ( > .05).

CONCLUSION

It was observed that EOIB showed similar analgesic activity to the OSTAP block. EOIB may also be a part of postoperative multimodal analgesia by reducing postoperative opioid consumption in LC.

摘要

背景

本研究旨在评估单侧肋间外神经阻滞(EOIB)在腹腔镜胆囊切除术手术中的有效性。

材料和方法

在伦理委员会批准后,纳入 ASA I-II 级、年龄 18-70 岁、拟行腹腔镜胆囊切除术的患者。将患者分为两组,肋间外神经阻滞组(EOIB 组)和斜肋下腹横肌平面阻滞组(OSTAP 组)。手术后,对 EOIB 或 OSTAP 阻滞组给予 20mL0.25%布比卡因,然后应用常规镇痛方案,给予静脉注射对乙酰氨基酚和曲马多。术后 24 小时监测视觉模拟评分(VAS)和患者自控镇痛(PCA)的消耗。对 VAS 评分≥4 的患者给予 25mg 哌替啶作为解救性镇痛。

结果

EOIB 组 36 例,OSTAP 组 34 例患者纳入研究。所有组的 VAS 评分均较低。在评估 PCA 消耗、副作用、解救性镇痛消耗和患者满意度时,组间无统计学差异(>.05)。

结论

EOIB 表现出与 OSTAP 阻滞相似的镇痛活性。EOIB 还可以通过减少 LC 术后阿片类药物的消耗,成为术后多模式镇痛的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f4b/11264529/d915abc95c21/10.1177_15533506241256529-fig1.jpg

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