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在50个连续病例中,在 laparoscopic 袖子胃切除术后,连续横向腹部平面阻塞
Yoona Chung1, Yong Jin Kim1, Suyeon Park2,3,4
1Metabolic and Bariatric Surgery Center, H+ Yangji Hospital, Seoul, Korea.
Journal of metabolic and bariatric surgery
|January 22, 2026
概括
持续的超声波引导的腹部横向平面 (TAP) 阻断了在腹腔镜袖子胃切除术 (LSG) 后24小时内减少阿片类药物和抗药物的需求. 这种经过手术后的增强恢复方案显示出对减肥手术的承诺.
科学领域:
- 腹部外科 腹部外科
- 疼痛管理 疼痛管理
- 区域麻醉地区麻醉
背景情况:
- 减肥手术后增强恢复对于减少并发症和改善患者结果至关重要.
- 超声导向横腹平面 (TAP) 阻断是一种已知的区域麻醉技术,可缓解术后疼痛并降低阿片类药物需求.
- 在腹腔镜袖子胃切除术 (LSG) 中调查持续TAP阻断的疗效可以优化术后护理.
研究的目的:
- 评估在接受LSG的患者中持续超声导向TAP阻断的有效性.
- 为了比较术后疼痛评分,阿片类药物消耗和持续TAP阻断治疗的患者与未接受TAP阻断治疗的患者之间的抗药要求.
- 在LSG的背景下评估连续TAP块的安全性和可行性.
主要方法:
- 50个连续的LSG病例使用了超声波引导的TAP块,数据与157个历史的LSG病例进行了比较.
- 使用超声指导进行TAP阻塞,确定用于导管插入的横向腹部平面.
- 0.5%的布皮瓦卡因通过连接到TAP导管的弹性进行注射.
主要成果:
- 虽然在患者人口统计或住院期间没有发现显著差异,但TAP区块组在24小时内减少了对阿片类药物注射的需求 (20%与36.82%相比).
- 此外,TAP组对24小时内注射拉莫塞 (抗药) 的需求也显著降低 (0%对9.45%).
- 两个病例经历了与导管切除相关的轻微并发症,需要局部麻醉.
结论:
- 持续的TAP阻断有效地减少了在LSG后的前24小时内需要额外的阿片类药物和抗药物的需求.
- 虽然累积阿片类药物消费量没有显著减少,但针对性地减少手术后立即需要的药物是临床相关的.
- 连续TAP阻断是LSG疼痛管理的可行辅助,有助于增强恢复协议.
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