腹腔镜辅助横腹部平面块块的皮肤感觉阻断区域
Christopher Blom Salmonsen1,2, Kai Henrik Wiborg Lange3,4, Christian Rothe3,4
1Department of Surgery, Copenhagen University Hospital - North Zealand Hospital, Hillerød.
laparoscopic-assisted transversus abdominis平面块 (L-TAP) 提供了一个可变的感觉阻断区域,主要是在腹膜区域. 这是一种盲目技术.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉 区域麻醉
- 手术疼痛管理手术疼痛管理
背景情况:
- 横腹平面 (TAP) 阻断技术和特征尚未得到充分描述.
- 准确的局部麻醉注射对于有效的TAP阻断至关重要.
- 腹腔镜辅助TAP (L-TAP) 是一种盲目技术,可能不如超声指导方法可靠.
研究的目的:
- 通过使用L-TAP. 评估皮肤感觉阻塞区域 (CSBA) 经过肋下双阻塞方法.
- 为了比较L-TAP与超声波引导技术的特性.
主要方法:
- 30名接受选择性腹腔镜胆囊切除术的患者接受了双边L-TAP.
- 使用感冒感觉和无菌标记器,在阻塞后150分钟绘制了CSBA的地图.
- 区块面积被照片记录,转移到透明表,并进行计算.
主要成果:
- 双边肋下L-TAP的中位数CSBA为161厘米2 (IQR: 131217厘米2).
- CSBA主要覆盖了腹上皮肤;23%的皮肤有下部件.
- 没有患者表现出CSBA横向延伸到前上下脊椎之外.
结论:
- 肋下双边双重L-TAP产生在中间上胃区域中异质的非皮肤性CSBA.
- 观察到的CSBA大小和分布与超声波导向下皮下TAP报告的情况相似.
- L-TAP显示出可变的疗效,突出了需要精确的技术或补充方法的需要.
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