Are the Analgesic Effects of Morphine Added to Transversus Abdominis Plane Block Systemic or Regional? A Randomized Clinical Trial.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Pain Research & Management Pub Date : 2025-03-12 eCollection Date: 2025-01-01 DOI:10.1155/prm/9187270
Meryem Onay, Osman Kaya, Elçin Telli, Ayten Bilir, Mehmet Sacit Güleç
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Abstract

Background: This study was designed to compare the effectiveness of the transversus abdominis plane (TAP) block with the addition of morphine to bupivacaine and the TAP block with bupivacaine plus intramuscular (IM) morphine. The aim of the study was to evaluate the effect of morphine administered with the TAP block on postoperative opioid consumption and pain scores and, secondarily, to determine whether the effect was systemic or local. Methods: This prospective, double-blind, randomized controlled trial included 52 patients. In the IM group, morphine at a dose of 0.1 mg/kg based on ideal body weight (IBW) was administered IM. In addition, a bilateral TAP block was performed under ultrasound guidance using a total of 40 mL of 0.25% bupivacaine, with 20 mL injected on each side. In the TAP group, an ultrasound-guided TAP block, including a total of 40 mL of 0.25% bupivacaine and 0.1 mg/kg morphine according to the IBW of patients, was administered bilaterally. Results: Total morphine consumption 24 h was 19.08 + 11.35 in the IM group and 11.81 + 7.02 in the TAP group, with an estimated difference in means of 7.2 (95% CI: 2.0, 12.5; p=0.008). The morphine consumption after 6, 12, and 24 h was lower in the TAP group than in the IM group (p=0.033, p=0.003, and p=0.008, respectively). The VAS scores at rest and during movement did not differ between the two groups. The total 24-h ondansetron consumption was higher in the IM group (p=0.046). The postoperative heart rates, blood pressure, and peripheral oxygen saturation at 0, 1, 6, 12, and 24 h did not differ significantly between the groups. Conclusions: The addition of morphine to the TAP block may be an effective method for postoperative analgesia in gynecologic surgery and may not increase systemic side effects, due to the possible local effects of morphine administered interfacial. Trial Registration: ClinicalTrials.gov identifier: NCT05420337.

吗啡的镇痛作用是全身性的还是区域性的?一项随机临床试验。
背景:本研究的目的是比较经腹面(TAP)阻滞与吗啡加布比卡因和TAP阻滞与布比卡因加肌内注射吗啡的效果。该研究的目的是评估吗啡与TAP阻滞对术后阿片类药物消耗和疼痛评分的影响,其次,确定这种影响是全身的还是局部的。方法:该前瞻性、双盲、随机对照试验纳入52例患者。IM组按理想体重(IBW) 0.1 mg/kg剂量注射吗啡。此外,在超声引导下,双侧TAP阻滞,使用0.25%布比卡因共40 mL,每侧注射20 mL。TAP组根据患者IBW,双侧给予超声引导下的TAP阻滞,包括0.25%布比卡因40 mL和0.1 mg/kg吗啡。结果:IM组24 h吗啡总用量为19.08 + 11.35,TAP组为11.81 + 7.02,估计平均值差异为7.2 (95% CI: 2.0, 12.5;p = 0.008)。TAP组6、12、24 h吗啡用量均低于IM组(p=0.033、p=0.003、p=0.008)。两组在休息和运动时的VAS评分没有差异。IM组24小时总丹司琼消耗量较高(p=0.046)。术后0、1、6、12和24 h的心率、血压和外周血氧饱和度在两组间无显著差异。结论:由于吗啡给药界面可能存在局部效应,在TAP阻滞基础上加用吗啡可能是妇科手术术后镇痛的有效方法,且不会增加全身副作用。试验注册:ClinicalTrials.gov标识符:NCT05420337。
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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来源期刊
Pain Research & Management
Pain Research & Management CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
0.00%
发文量
109
审稿时长
>12 weeks
期刊介绍: Pain Research and Management is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of pain management. The most recent Impact Factor for Pain Research and Management is 1.685 according to the 2015 Journal Citation Reports released by Thomson Reuters in 2016.
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