在腹腔镜修复中比较周围体M-TAPA和下腰椎OSTAP阻塞:一个随机的,非劣势试验
Selçuk Alver1, Bahadır Çiftçi1, İnanç Koruk1
1Department of Anesthesiology and Reanimation, İstanbul Medipol University, İstanbul, Türkiye.
概括
经过周粒体方法 (M-TAPA) 修改的胸腔腹部神经阻塞是一种可行的替代方案,可以代替斜腰下腰横腹平面阻塞 (OSTAP),用于经过腹腔镜 inguinal hernia 修复后的疼痛管理,提供可比的疗效和提高患者满意度.
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:
- 经过修改的胸腔腹部神经通过周周体接近 (M-TAPA) 和斜肋下横向腹部平面阻断 (OSTAP) 进行阻断,对于腹部手术后的止痛是有效的.
- 对于这两种区域麻醉技术,只有有限的比较研究存在.
研究的目的:
- 为了比较M-TAPA与OSTAP在进行腹腔镜 inguinal hernia修复的患者中的疗效和安全性.
- 为了评估术后疼痛,救援止痛要求和患者满意度.
主要方法:
- 对接受选择性TAPP的18-65岁患者 (ASA I-II) 的随机研究.
- 两个组:M-TAPA (n=30) 和OSTAP (n=30),两组都接受了60毫升0.25%的布皮瓦卡因.
- 手术后的护理包括定期服用布洛芬和特拉马多尔治疗突破性疼痛 (NRS ≥4).
主要成果:
- 欧斯塔普阻断程序的持续时间比M-TAPA长.
- 救援止痛需求和阿片类药物消费在各组之间是相似的.
- M-TAPA组的术后NRS得分较低 (前2小时),患者满意度更高.
结论:
- 在腹腔镜上修复 inguinal hernia 时,M-TAPA 的阻断效果与 OSTAP 的效果无差.
- M-TAPA为术后止痛提供了一个潜在的更容易应用的替代方案.
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