在腹腔镜直肠手术后进行术后止痛的横腹部平面阻塞
概括
腹部横平面 (TAP) 阻断显著减少腹腔镜直肠手术后的疼痛和止痛需要. 这种区域麻醉技术改善了患者的康复和舒适,增强了微创手术的好处.
科学领域:
- 外科瘤学
- 区域麻醉
- 治疗疼痛
背景情况:
- laparoscopic直肠切除比开放手术具有优势,包括更快的恢复和减少疼痛.
- 优化术后疼痛管理对于改善腹腔镜手术后患者的结果至关重要.
- 穿越腹部平面 (TAP) 阻断是一种区域麻醉技术,有可能改善疼痛缓解.
研究的目的:
- 评估TAP阻断在腹腔镜直肠切除后治疗术后疼痛的有效性.
- 评估TAP阻断对止痛药消耗和患者舒适性的影响.
- 突出将TAP块整合到多式止痛方案中的好处.
主要方法:
- 包括接受选择性腹腔镜直肠手术的成年患者的前性观察队列研究.
- 用0. 25%的罗皮瓦卡因进行超声指导的双边TAP阻断.
- 使用视觉模拟尺度 (VAS) 进行术后疼痛评估,并记录止痛药的消耗 (阿片类药物, acetamol,tramadol).
主要成果:
- 在TAP阻断组中降低了对类药物的消耗 (p=0. 011).
- 在TAP组中,延长至第一次止痛的中位时间 (8小时对5小时,p=0. 001).
- TAP阻断显示增强了疼痛缓解并延长了疼痛缓解的持续时间.
结论:
- 在腹腔镜结直肠手术中,TAP阻塞在多模式止痛中具有很高的效果.
- 它显著降低了阿片类和非阿片类止痛药的需求,改善了患者的舒适度.
- 将TAP阻断纳入外科手术方案可以优化患者的治疗结果, 需要进一步的研究.
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