首页> 外文期刊>Indian journal of Anaesthesia >Comparison of laparoscopy-guided with ultrasound-guided subcostal transversus abdominis plane block in laparoscopic cholecystectomy – A prospective, randomised study
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Comparison of laparoscopy-guided with ultrasound-guided subcostal transversus abdominis plane block in laparoscopic cholecystectomy – A prospective, randomised study

机译:腹腔镜引导腹膜镜脊髓型腹腔镜平面腹腔镜腹膜镜斜纹术中的比较 - 一种预期,随机研究

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Background and Aims: Subcostal transversus abdominis plane (TAP) block is usually done under ultrasound guidance in laparoscopic cholecystectomy. Laparoscopic-guided subcostal TAP block is an alternate technique where ultrasound is not available. Our primary objective was to compare the success rate of ultrasound and laparoscopic approaches to the subcostal TAP block. The secondary objectives were to assess the duration of postoperative analgesia and morphine consumption postoperatively for 24 h. Methods: Eighty patients undergoing laparoscopic cholecystectomy were randomly divided into two groups with patients receiving ultrasound-guided (group U) or laparoscopy-guided (group L) subcostal TAP block at the end of surgery. The success rate was assessed by a sensory blockade of T7 and T8 dermatomes 30 min after extubation. The duration of analgesia was taken as time from block administration to the visual analogue scale of ≥3. Morphine was administered in patient-controlled analgesia (PCA) pump with a bolus of 1 mg and a lock-out interval of 10 min. The total morphine consumption was recorded. The statistical analysis was performed with student t-test and Chi-square test. Results: The success rate of group U (100%) was higher than group L (88%) but it was not statistically significant (P = 0.054). The duration of postoperative analgesia was significantly prolonged in group U (867.24 ± 135.83 min) than group L (751.31 ± 311.22 min) (P = 0.033). Morphine consumption was also less in group U (4.72 ± 0.94 mg) than group L (5.57 ± 2.53 mg) (P = 0.049). There was no significant difference in the VAS scores after 4 h postoperatively. Conclusion: Laparoscopy-guided subcostal TAP block is a suitable alternative to ultrasound-guided block and can be utilised in places where an ultrasound machine is not available.
机译:背景和目的:椎间盘突出的腹膜镜胆囊切除术中的超声引导通常在超声引导下进行亚骨升压越桔。腹腔镜引导的亚平螺杆块是替代技术,其中超声波不可用。我们的主要目标是将超声波和腹腔镜接近的成功率与亚挡板进行比较。次要目标是评估术后镇痛和术后24小时术后镇痛和吗啡消费的持续时间。方法:腹腔镜胆囊切除术的八十名患者随机分为两组,患者在手术结束时接受超声引导(u)或腹腔镜检查(L)骨髓间隔块的患者。拔管后30分钟的T7和T8皮肤的感官封锁评估了成功率。镇痛的持续时间是从嵌段给药到≥3的视觉模拟量表的时间。在患者控制的镇痛(PCA)泵中给予吗啡,用1mg的推注和10分钟的锁定间隔。记录了总体的药物消费量。统计学分析与学生T检验和Chi-Square测试进行。结果:U(100%)的成功率高于L(88%),但它没有统计学意义(P = 0.054)。术后镇痛的持续时间大于1组(867.24±135.83分钟)显着延长(751.31±311.22分钟)(P = 0.033)。组U(4.72±0.94mg)的吗啡消耗量比L(5.57±2.53mg)(p = 0.049)。术后4小时后VAS分数没有显着差异。结论:引导腹腔镜引导的亚挡块是超声波引导块的合适替代方案,可以在超声波机器不可用的地方使用。

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