经典的TAP与传统的TAP. 在选择性剖腹产中使用相同剂量的局部麻醉剂:一项随机对照试验
Wessam Zakaria El-Amrawy1, Ahmed Mohamed El-Attar2
1Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, Egypt. wesam.amrawy@alexu.edu.eg.
结合的 ilioinguinal iliohypogastric (ILIH) 和横腹平面 (TAP) 阻断 (ITAP) 与剖腹产后单独的 TAP 阻断相比,提供了优异的术后疼痛缓解. 接受ITAP阻塞的患者需要更少的止痛,并报告了更高的满意度.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 在剖腹产后有效的术后疼痛控制对于母婴结合,愈合和早期出院至关重要.
- 横向腹部平面 (TAP) 和 ilioinguinal iliohypogastric (ILIH) 阻塞用于减少阿片类药物消费,但它们的比较疗效尚未得到充分证实.
- 下段剖腹产 (LSCS) 患者经常经历明显的术后疼痛,需要优化止痛策略.
研究的目的:
- 为了比较超声导向TAP阻断与结合超声导向TAP阻断与ILIH神经阻断 (ITAP) 在LSCS后减少术后止痛需求的有效性.
- 评估ITAP阻断对疼痛评分,首次止痛要求的时间,救援止痛消耗和患者满意度的影响.
主要方法:
- 一项随机对照试验,涉及210名接受LSCS的患者.
- 患者被分配到使用相同的局部麻醉剂体积接受超声导向TAP阻塞或超声导向ITAP阻塞.
- 疼痛管理,救援止痛药使用 (纳尔布芬) 和患者满意度由盲人观察员在多个时间点评估,直至手术后24小时.
主要成果:
- 与TAP组相比,ITAP组在术后几个小时 (2,3,4,8,12,16,20,24) 显示了静止疼痛得分的显著降低.
- ITAP组的患者在第一次请求止痛之前经历了显着较长的延迟 (13.15±1.85小时),而不是TAP组 (10.06±1.61小时).
- 在ITAP组中,纳尔布芬消费量显著下降,患者满意度得分更高.
结论:
- 结合的ITAP阻断提供了优质的术后止痛,与单独的TAP阻断相比,在LSCS之后.
- 阻断ITAP是改善剖腹产后疼痛管理和患者满意度的有效策略.
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