Background

Despite the extensive administration of the enhanced recovery after surgery (ERAS) program, postoperative pain remains a major concern for patients. Transversus abdominis plane (TAP) block and local wound infiltration (LWI) are two techniques that have been widely applied in abdominal surgery. However, these two techniques have rarely been compared in terms of their analgesic effects on patients that undergo laparoscopic colorectal surgery with the ERAS program.

Methods

A randomized, double-blinded study was conducted in this study. Briefly, 174 patients that underwent colorectal surgery with the ERAS program were randomly allocated to TAP block treatment (TAP group) or local wound infiltration (LWI group). All patients were assessed for their pain scores at rest and in motion at 6, 24, 48, and 72 h after surgery. The administration frequency of bolus for PCIA and the use amount of rescue analgesics (parecoxib) were recorded. Finally, the patients were monitored with follow-up surveys on their postoperative function recovery, complications, lengths of stay, treatment cost, and satisfaction.

Results

In terms of the pain scores at rest and in motion, the two groups revealed no significant difference throughout the study sessions, and no difference was found in the administration frequency of bolus and the use amount of parecoxib. Moreover, the two groups demonstrated similar results in their postoperative recovery, and no significant differences were found in terms of postoperative complications.

Conclusions

Compared with local wound infiltration, transversus abdominis plane block is not significantly advantageous for postoperative pain control and recovery in patients undergoing laparoscopic colorectal surgery with the ERAS program. However, local wound infiltration might be preferred since it is available with less technical difficulties.

中文翻译：

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腹横肌平面阻滞与局部伤口浸润对腹腔镜结直肠癌切除术后疼痛的影响：一项随机、双盲研究

背景

尽管广泛实施了加速术后恢复 (ERAS) 计划，但术后疼痛仍然是患者的主要关注点。腹横肌平面（TAP）阻滞和局部伤口浸润（LWI）是两种广泛应用于腹部手术的技术。然而，很少有人比较这两种技术对使用 ERAS 计划进行腹腔镜结直肠手术的患者的镇痛效果。

方法

本研究进行了一项随机、双盲研究。简而言之，174 名接受 ERAS 计划的结直肠手术患者被随机分配到 TAP 阻滞治疗（TAP 组）或局部伤口浸润（LWI 组）。术后 6、24、48 和 72 小时评估所有患者在休息和运动时的疼痛评分。记录PCIA推注给药频率和抢救性镇痛药（帕瑞昔布）的使用量。最后，对患者进行术后功能恢复、并发症、住院时间、治疗费用和满意度的随访调查。

结果

在休息和运动时的疼痛评分方面，两组在整个研究过程中没有发现显着差异，并且在推注给药频率和帕瑞昔布的使用量方面没有发现差异。此外，两组在术后恢复方面表现出相似的结果，并且在术后并发症方面没有发现显着差异。

结论

与局部伤口浸润相比，腹横肌平面阻滞对采用 ERAS 计划的腹腔镜结直肠手术患者的术后疼痛控制和恢复没有显着优势。然而，局部伤口浸润可能是首选，因为它的技术难度较小。