ラパロスコピック直腸手術後の術後の鎮痛のための横腹部平面ブロック
まとめ
腹部横平面 (TAP) ブロックは,腹腔鏡による大腸内外科手術後の痛みと鎮痛剤の必要性を大幅に軽減します. この地域麻酔技術は 患者の回復と快適さを改善し 侵襲性の少ない処置の利点を高めます
科学分野:
- 手術腫瘍学
- 地域麻酔
- 痛みの管理
背景:
- laparoscopic colorectal resectionは オープン手術よりも 回復速度が速く 痛みが軽減されるという利点があります
- 術後の痛みの管理を最適化することは 腹腔鏡手術後の患者の治療結果を改善するために不可欠です
- 横腹部平面 (TAP) ブロックは,潜在的に鎮痛を改善できる地域麻酔技術です.
研究 の 目的:
- 腹腔鏡による大腸切除後の術後の痛みの管理におけるTAPブロックの有効性を評価する.
- 鎮痛剤の消費と患者の快適さに対する TAP ブロックの影響を評価する.
- 多様性鎮痛プロトコルに TAP ブロックを統合することの利点を強調する.
主な方法:
- 選択性腹腔鏡直腸外科手術を受けた成人の患者を含む前向きな観察コホート研究.
- 0. 25%のロピヴァカインによる超音波誘導の双方向TAPブロック
- 視覚アナログスケール (VAS) を用いた術後の痛みの評価と鎮痛剤 (オピオイド,パラセタモール,トラマドール) の摂取記録
主要な成果:
- TAPブロック群におけるパラセタモールの消費量の有意な減少 (p=0. 011).
- TAPブロック群における最初の鎮痛薬要求までの期間 (8時間対5時間,p=0. 001)
- TAPブロックは鎮痛効果を高め,痛みの緩和期間を延長しました.
結論:
- TAPブロックは,腹腔鏡による大腸内外科手術のマルチモダル鎮痛に非常に有効です.
- オピオイドと非オピオイドの鎮痛剤の必要性を大幅に減らし 患者の快適さを向上させます
- TAPブロックを外科プロトコルに統合することで,患者の治療結果を最適化し,さらなる調査が必要となる.
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