Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review.

IF 1.5 Q3 ANESTHESIOLOGY
Local and Regional Anesthesia Pub Date : 2020-10-23 eCollection Date: 2020-01-01 DOI:10.2147/LRA.S272694
James Harvey Jones, Robin Aldwinckle
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引用次数: 8

Abstract

Laparoscopic abdominal surgery has become a mainstay of modern surgical practice. Postoperative analgesia is an integral component of recovery following laparoscopic abdominal surgery and may be improved by regional anesthesia or intravenous lidocaine infusion. There is inconsistent evidence supporting the use of interfascial plane blocks, such as transversus abdominis plane (TAP) blocks, for patients undergoing laparoscopic abdominal surgery as evidenced by variable patterns of local anesthetic spread and conflicting results from studies comparing TAP blocks to local anesthetic infiltration of laparoscopic port sites and multimodal analgesia. Quadratus lumborum (QL) and erector spinae plane (ESP) blocks may provide greater areas of somatic analgesia as well as visceral analgesia, which may translate to more significant clinical benefits. Aside from the locations of the surgical incisions, it is unclear what other factors should be considered when choosing one regional technique over another or deciding to infuse lidocaine intravenously. We reviewed the current literature in attempt to clarify the roles of various regional anesthesia techniques for patients undergoing laparoscopic abdominal surgery and present one possible approach to evaluating postoperative pain.

筋膜间平面阻滞与腹腔镜腹部手术:叙述性回顾。
腹腔镜腹部手术已成为现代外科实践的支柱。术后镇痛是腹腔镜腹部手术后恢复的重要组成部分,可以通过区域麻醉或静脉输注利多卡因来改善。支持对腹腔镜腹部手术患者使用筋膜间面阻滞,如腹横面阻滞(TAP)的证据不一致,这可以从不同的局麻扩散模式和将TAP阻滞与腹腔镜端口部位局麻浸润和多模式镇痛进行比较的研究中得到矛盾的结果。腰方肌(QL)和竖脊肌平面(ESP)阻滞可能提供更大范围的躯体镇痛和内脏镇痛,这可能转化为更显著的临床益处。除了手术切口的位置外,在选择一种局部技术或决定静脉注射利多卡因时,还应考虑哪些其他因素尚不清楚。我们回顾了目前的文献,试图阐明各种区域麻醉技术在腹腔镜腹部手术患者中的作用,并提出了一种评估术后疼痛的可能方法。
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
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
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