比较腹腔镜腹疝修补术中经腹平面阻滞和肝部浸润:一项随机对照试验。

IF 1.1 4区 医学 Q3 SURGERY
Sourabh Singh, Himanshu Agrawal, Nikhil Gupta, Nitin Agarwal, Aditya Kumar, Shailesh Kumar
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引用次数: 0

摘要

引言:充分的镇痛对于腹腔镜腹疝修补术(LVHR)患者的顺利康复至关重要。TAP阻滞和端口部位浸润(PSI)是缓解疼痛最常用的两种方法。因此,本研究比较腹腔镜引导下TAP阻滞与PSI对LVHR术后镇痛、住院时间和镇痛药抢救剂量的影响。患者和方法:这项单盲随机对照试验于2023年4月1日至2024年8月1日在德里的一家三级医院进行。共有60名患者入组。随机化使用计算机生成的随机数表,分配使用顺序编号的不透明密封信封。所有年龄在18岁至18岁之间的前腹壁疝行LVHR的患者都被纳入研究。排除有阿片类药物使用史的患者、过去6个月内有酗酒史的患者、疝大小为bb0 ~ 6cm的患者。两组包括:试验组(A组)-腹腔镜辅助TAP阻滞(LTAP)和对照组(B组)-端口局麻浸润(PSLAI)。结果:在LVHR中,与PSLAI相比,TAP阻滞的使用显示出更好的疼痛管理(LTAP组在术后6、12和24小时的VAS评分显著低于PSLAI组[P分别= 0.0031、0.0037和0.00012])。LTAP与较短的住院时间(P = 0.016)和较少的救急镇痛需求(P = 0.031)相关。结论:腹腔镜横腹平面阻滞术在术后镇痛效果上优于肝口局麻浸润术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing laparoscopic transversus abdominis plane block and port-site infiltration in laparoscopic ventral hernia repair: A randomised controlled trial.

Introduction: Adequate analgesia is of utmost importance for apposite in patients undergoing laparoscopic ventral hernia repair (LVHR) for smooth recovery. TAP block and port-site infiltration (PSI) are two most commonly employed methods for pain relief. Therefore, this study was done to compare laparoscopic-guided TAP block versus PSI for post-operative analgesia, hospital stay and rescue dose of analgesic in LVHR.

Patients and methods: This single-blinded randomised controlled trial was done in a tertiary hospital of Delhi from 1 April 2023, to 1 August 2024. A total of 60 patients were enrolled. Randomisation was done using computer-generated random number table, and allotment was done using sequentially numbered opaque sealed envelopes. All patients >18 years of age with anterior abdominal wall hernia undergoing LVHR were included in the study. Patients with a history of opioid usage, patients with alcohol abuse within the past 6 months, patients with hernia size >6 cm were excluded from the study. Two groups included: test group (Group A) - laparoscopic-assisted TAP block (LTAP) and control Group (Group B) - port-site local anaesthesia infiltration (PSLAI).

Results: In LVHR, the use of TAP blocks showed superior pain management compared to PSLAI (significantly lower VAS scores at 6, 12 and 24-h post-surgery in the LTAP group [P = 0.0031, 0.0037 and 0.00012, respectively]). LTAP was associated with a shorter hospital stay (P = 0.016) and less need for rescue analgesia (P = 0.031).

Conclusion: Laparoscopic transverse abdominis plane block is superior to port-site local anaesthesia infiltration in providing effective post-operative analgesia.

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来源期刊
CiteScore
1.70
自引率
0.00%
发文量
151
审稿时长
36 weeks
期刊介绍: Journal of Minimal Access Surgery (JMAS), the official publication of Indian Association of Gastrointestinal Endo Surgeons, launched in early 2005. The JMAS, a quarterly publication, is the first English-language journal from India, as also from this part of the world, dedicated to Minimal Access Surgery. The JMAS boasts an outstanding editorial board comprising of Indian and international experts in the field.
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