Comparison of Intrathecal Morphine versus Ultrasound-Guided Regional Analgaesia Techniques for Post-Caesarean Recovery Quality.

Mahmut Semih Akdag, Munise Yildiz, Nur Gozde Kulhan, Mahmut Sami Tutar, Betul Kozanhan
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Abstract

Objective: To investigate the impact of ultrasound-guided regional analgaesia techniques on postoperative recovery and compare them with those of intratecal morphine (ITM) in obstetric patients undergoing elective caesarean delivery (CD).

Study design: Observational study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Konya City Hospital, Konya, Turkiye, from January to December 2022.

Methodology: The study involved six groups of 30 patients each, categorised by postoperative analgaesia: ITM, posterior transversus abdominis plane block (TAPB), lateral TAPB, transversalis fascia plane block, posterior quadratus lumborum block, and erector spinae plane block. Recovery was assessed using the Obstetric Quality of Recovery Score-10 (ObsQoR-10) at 24 hours, whereas satisfaction was measured with a Likert scale. Time to the first analgaesia, total opioid consumption, nausea, and the need for antiemetics were compared.

Results: ObsQoR-10, satisfaction, and numerical rating scale scores were consistent across groups (p >0.05). The lateral TAPB group required more opioids and had earlier analgaesic requests (p = 0.009 and p = 0.05, respectively). ITM was more likely to cause nausea and pruritus compared to regional analgaesia techniques (p = 0.062 and p <0.001).

Conclusion: Ultrasound-guided regional analgaesia techniques provided similar postoperative recovery and patient satisfaction levels as ITM. Moreover, regional analgaesia techniques, except lateral TAPB, may offer similar alternatives to ITM within multimodal analgaesia strategies for CD.

Key words: Caesarean delivery, Multimodal analgaesia, Patient-reported outcome, Regional analgaesia techniques, Quality of recovery.

鞘内吗啡与超声引导下局部镇痛技术对剖宫产后恢复质量的比较。
目的:探讨超声引导下局部镇痛技术对产科择期剖宫产(CD)患者术后恢复的影响,并与肠内吗啡(ITM)进行比较。研究设计:观察性研究。研究地点和时间:2022年1月至12月,土耳其科尼亚市科尼亚市医院麻醉与复苏科。方法:本研究包括6组患者,每组30例,按术后镇痛方式进行分类:ITM、后腹横肌平面阻滞(TAPB)、外侧TAPB、筋膜横肌平面阻滞、后腰方肌阻滞和竖脊肌平面阻滞。在24小时内使用产科恢复质量评分-10 (ObsQoR-10)评估恢复情况,而使用李克特量表测量满意度。比较第一次镇痛的时间、阿片类药物的总消耗量、恶心程度和止吐药的需求。结果:ObsQoR-10、满意度和数值评定量表得分各组间一致(p < 0.05)。侧侧TAPB组需要更多的阿片类药物,镇痛要求更早(p = 0.009和p = 0.05)。与局部镇痛技术相比,ITM更容易引起恶心和瘙痒(p = 0.062和p)。结论:超声引导下的局部镇痛技术与ITM具有相似的术后恢复和患者满意度。此外,除了外侧TAPB外,局部镇痛技术可能在cd的多模式镇痛策略中提供类似于ITM的替代方案。关键词:剖腹产,多模式镇痛,患者报告的结果,局部镇痛技术,恢复质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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