当前位置： SCI文献检索 > BRITISH JOURNAL OF ANAESTHESIA期刊下所有文献 > Analgesic efficacy of bilateral continuous transversus abdominis plane blocks using an oblique subcostal approach in patients undergoing laparotomy for gynaecological cancer: a prospective, randomized, triple-blind, placebo-controlled study.

Analgesic efficacy of bilateral continuous transversus abdominis plane blocks using an oblique subcostal approach in patients undergoing laparotomy for gynaecological cancer: a prospective, randomized, triple-blind, placebo-controlled study.

Abstract：

BACKGROUND:The analgesic efficacy of continuous transversus abdominis plane (TAP) blocks in comparison with that of single-injection TAP blocks is not clear. This randomized, triple-blind, placebo-controlled trial investigated the benefits of adding continuous TAP blocks to single-injection TAP blocks after a laparotomy. METHODS:Eighty consecutive patients undergoing midline laparotomy for gynaecological cancer were randomized and received bilateral TAP infusions with either ropivacaine 0.1% (n=40, Rop group) or normal saline (n=40, NS group) at 10 ml h-1 per side for 50 h after surgery. After surgery, bilateral oblique subcostal TAP blocks were performed using ropivacaine 0.1%, 50 ml per side, and then catheters were threaded into the bilateral TAPs. Subsequently, continuous TAP infusions and patient-controlled i.v. morphine administration were initiated. The primary outcome was cumulative morphine consumption by 24 h after TAP catheter placement. Secondary outcomes included pain scores, postoperative nausea and vomiting severity, and time to first ambulation and flatus. RESULTS:The cumulative morphine consumption (median [interquartile range]) 24 h after TAP catheter placement was lower in the Rop group (0.25 [0.11-0.48] mg kg-1) than in the NS group (0.44 [0.24-0.73] mg kg-1; 95% confidence interval difference in medians, -0.30 to - 0.03; P=0.01). No statistically significant differences were observed in the secondary outcomes, except for reduced pain scores in the Rop group obtained during coughing 1 and 24 h after TAP catheter placement. CONCLUSIONS:Addition of continuous TAP blocks to single-injection TAP blocks reduces pain and morphine consumption after a laparotomy for gynaecological cancer. CLINICAL TRIAL REGISTRATION:UMIN Clinical Trials Registry identification number UMIN000013449 (http://www.umin.ac.jp/ctr/index.htm).

journal_name

Br J Anaesth

journal_title

British journal of anaesthesia

authors

Yoshida T,Furutani K,Watanabe Y,Ohashi N,Baba H

doi

10.1093/bja/aew339

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

812-820

issue

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)37204-5

journal_volume

117

pub_type

杂志文章

在线工具

Analgesic efficacy of bilateral continuous transversus abdominis plane blocks using an oblique subcostal approach in patients undergoing laparotomy for gynaecological cancer: a prospective, randomized, triple-blind, placebo-controlled study.