【罂粟摘要】超声引导腹横筋膜平面阻滞用于剖宫产术后镇痛的评价:前瞻性、随机、对照临床试验
超声引导腹横筋膜平面阻滞用于剖宫产术后镇痛的评价
剖宫产(CD)是一种常见的产科手术。在CD患者多模式镇痛中加入区域麻醉技术，可提高术后镇痛质量。在这项研究中，我们评估了腹横筋膜平面阻滞（TFPB）在CD术后镇痛管理中的疗效。
盲法、前瞻性、随机研究。
土耳其伊斯坦布尔三级大学医院术后恢复室和病房
75例（ASA II-III）计划进行剖宫产的患者。排除不符合标准的病例后，将70例患者随机分为两组（阻滞组和对照组）。
对照组采用标准多模式镇痛（常规乙酰氨基酚、曲马多PCA加双氯芬酸钠作为抢救性镇痛），干预组采用TFPB阻滞。
主要结果是术后24小时内曲马多的用量。次要结果是休息和运动/咳嗽期间的数字评定量表（NRS）评分。
对照组术后24小时内的曲马多用量为175 ± 72.32 mg，TFPB组为 101.42 ± 51.45 mg（p<0.05）。TFPB组在术后前3小时内和术后第12小时的NRS评分较低。其他时间NRS评分无差异。
超声引导下双侧TFPB能有效缓解CD患者术后疼痛并减少术后24小时内的镇痛需求。
Serifsoy TE, Tulgar S, Selvi O, et al. Evaluation of ultrasound-guided transversalis fascia plane block for postoperative analgesia in cesarean section: A prospective, randomized, controlled clinical trial.[J].J Clin Anesth. 2020 Feb;59:56-60. doi: 10.1016/j.jclinane.2019.06.025.
Evaluation of ultrasound-guided transversalis fascia plane block for postoperative analgesia in cesarean section: A prospective, randomized, controlled clinical trial
Study objective
Cesarean Delivery (CD) is a commonly performed obstetric procedure. Adding a regional anesthesia technique to multimodal analgesia in CD, may improve the quality of postoperative analgesia. In this study we evaluated the efficacy of Transversalis Fascia Plane Block (TFPB) for postoperative analgesia management in CD.
Design
Blinded, prospective, randomized study.
Setting
Postoperative recovery room & ward, tertiary university hospital, Istanbul, Turkey
04
Patients
Seventy-five patients (ASA II-III) scheduled to undergo Cesarean delivery were recruited. Following exclusion, 70 patients were randomized into two equal groups (block and control group).
Interventions
Standard multimodal analgesia (routine paracetamol and tramadol PCA in addition to diclophenac sodium as rescue analgesia) was performed in Group C while TFPB block was also performed in the intervention (TFPB) group.
Measurements
The primary outcome was tramadol consumption within the first 24 h. The secondary outcome was Numeric Rating Scale (NRS) scores during rest and movement/coughing.
Main results
Tramadol consumption in the first 24 h was 175 ± 72.32 mg in the control and 101.42 ± 51.45 mg in the TFPB group (p < 0.05). NRS was lower in Group TFPB during the first 3 h and at the 12th hour. There was no difference in NRS scores at other hours.
Conclusion
Bilateral ultrasound guided TFPB leads to effective analgesia and a decrease in analgesia requirement in first 24 h in patients undergoing CD.
翻译：冯玉蓉
编辑：冯玉蓉 佟睿
审校：曹莹