两阶段腹腔镜横向腹部平面块作为相当于胸部外周麻醉在肠切除的替代方案 - - 一项探索性队列研究
M Kaufmann1, V Orth1, T-J Dorwarth1
1Department of Surgery, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany.
与胸外外麻醉 (TEA) 和单阶段L-TAPB (OS-L-TAPB) 相比,双阶段腹腔镜横向腹部平面阻塞 (TS-L-TAPB) 在接受肠切除的患者中显著减少了术后阿片类药物的使用. 这为治疗疼痛提供了临床上有益的替代方案.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
背景情况:
- 手术后的疼痛控制对于腹腔镜肠切除后的恢复至关重要.
- 像胸部外周麻醉 (TEA) 这样的传统方法也有局限性.
- 腹腔镜横向腹部平面块 (L-TAPB) 是一种替代区域麻醉技术.
研究的目的:
- 为了比较两阶段L-TAPB (TS-L-TAPB) 与胸部外周麻醉 (TEA) 和一阶段L-TAPB (OS-L-TAPB) 的疗效.
- 评估在接受选择性腹腔镜肠切除的患者手术后的阿片类药物需求.
主要方法:
- 进行了TS-L-TAPB (双边,手术前后) 的前性评估.
- 数据与接受TEA或OS-L-TAPB的患者的回顾性队列进行了比较.
- 手术后的口服和静脉注射阿片类药物消费记录了三天.
主要成果:
- 与TEA和OS-L-TAPB相比,TS-L-TAPB在术后第三天显示出较低的累积阿片类药物需求.
- 虽然最初TEA组中更多的患者在康复后不需要阿片类药物,但这种差异缺乏临床相关性.
- 在术后第3天,TEA患者比TS-L-TAPB和OS-L-TAPB组接受的阿片类药物显著更多.
结论:
- TS-L-TAPB提供了统计学上显著和临床上有意义的降低术后阿片类药物需求.
- 这种技术在腹腔镜肠切除后的疼痛管理方面比TEA和OS-L-TAPB都有优势.
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