超声引导下腹横肌平面阻滞联合患者纳布啡静脉自控镇痛在剖腹手术后镇痛中的应用：一项随机对照试验

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  超声引导下腹横肌平面阻滞联合患者纳布啡静脉自控镇痛在剖腹手术后镇痛中的应用：一项随机对照试验  

贵州医科大学  麻醉与心脏电生理课题组

翻译：邓举   编辑：潘志军   审校：曹莹

背景： 疼痛是术后常见的并发症。理想的术后镇痛方法是清醒、安全、可活动，无副作用。本研究的目的是通过观察不同镇痛方法对剖腹手术患者的安全性和镇痛效果，为术后镇痛提供新的思路。 方法： 在2019年9月至2020年12月期间接受剖腹手术的患者被随机分为三组：S组接受舒芬太尼，N组接受纳布啡，T+N组术后接受双侧腹横肌平面阻滞(TAPB)和纳布啡治疗。主要结果包括视觉模拟评分(VAS)评分和术后镇痛泵的使用。次要结果包括生活质量恢复量表(QoR-15)评分和术后不良反应的发生率。 结果: 与S组和N组相比，T+N组术后48h静息VAS评分、术后12h动态VAS评分、第一次按压时间、24h患者自控静脉镇痛(PCIA)累计使用药物有统计学意义 (P <0.05)。T+N组术后48h内的QoR-15评分值显著高于N组（P<0.05）。T组第一次排气时间和恶心呕吐的发生率显著低于N组（P<0.05）。      

结论: 舒芬太尼PCIA和纳布啡PCIA具有相同的镇痛效果，而TAPB联合纳布啡PCIA可保证良好的镇痛效果，从而减少不良反应的发生率。    

原始文献来源：

Kunyu Han . Yuhe Zhang . Ruiping Bai,et al. Application of Ultrasound-Guided Transversus  Abdominis Plane Block Combined with Nalbuphine

Patient-Controlled Intravenous Analgesia in Postoperative Analgesia After Laparotomy: A Randomized Controlled Trial.［J］Pain Ther (2022) 11:627–641

罂粟花  

Application of Ultrasound-Guided Transversus

Abdominis Plane Block Combined with Nalbuphine Patient-Controlled Intravenous Analgesia in Postoperative Analgesia After Laparotomy: A Randomized Controlled Trial

Abstract

Introduction:

Pain is a common postoperative complication. The ideal postoperative analgesia is awake, safe, mobile, and without side effects.The objective of this study is to provide new ideas for postoperative analgesia by observing the safety and analgesic effect of different analgesic methods in patients undergoing laparotomy after surgery.

Method:

Patients, who underwent laparotomy between September 2019 and December 2020, were randomly divided into three groups: group S received sufentanil, group N received nalbuphine, group T + N received postoperative bilateral transversus abdominis plane block (TAPB) and nalbuphine. The primary outcomes included visual analog scale (VAS) score and the use of postoperative analgesic pump. Secondary outcomes included quality of life recovery (QoR-15) scale score and incidence of postoperative adverse reactions.

Results:

Compared with group S and N, there were signifificant differences in the resting VAS score within 48 h after surgery, dynamic VAS score within 12 h after surgery, the first compression time, and cumulative use of patient controlled intravenous analgesia (PCIA) drugs at 24 h in group T + N (P <0.05). The QoR-15 score within 48 h after surgery in group T + N was significantly higher than group N (P<0.05). The first exhaust time and the incidence of nausea and vomiting in group T +N were signifificantly lower than those in group N (P <0.05).

Conclusion:

Sufentanil PCIA and nalbuphine PCIA have equivalent analgesic effects, while TAPB combined with nalbuphine PCIA can ensure a good analgesic effect, thereby reducing the incidence of adverse reactions.

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