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Impact of Bilateral Subcostal Plus Lateral Transversus Abdominis Plane Block on Quality of Recovery After Laparoscopic Cholecystectomy: A Randomized Placebo-Controlled Trial
Anesthesia & Analgesia ( IF 5.7 ) Pub Date : 2021-09-30 , DOI: 10.1213/ane.0000000000005762
Jaewoong Jung , Woohyun Jung , Eun Young Ko , Yang-Hoon Chung , Bon-Sung Koo , Jun Chul Chung , Sang-Hyun Kim

ocks to multimodal analgesia would improve the quality of recovery as assessed with the Quality of Recovery-40 (QoR-40). METHODS: Patients age 18 to 60 years who were scheduled to undergo elective laparoscopic cholecystectomy were randomized to the BD-TAP or control group. The BD-TAP group received the BD-TAP block with multimodal analgesia under general anesthesia, using 0.25% ropivacaine, and the control group was treated with the same method, except that they received the sham block using 0.9% normal saline. Both groups had the same multimodal analgesia regimen, consisting of intravenous dexamethasone, propacetamol, ibuprofen, and oxycodone. The primary outcome was the QoR-40 score at 24 hours after surgery. Data were analyzed using the independent t test, Mann-Whitney U test, χ2 test, and Fisher exact test. RESULTS: Thirty-eight patients in each group were recruited. The mean QoR-40 score decreased by 13.6 (95% confidence interval [CI], 8.3–18.8) in the BD-TAP group and 15.6 (95% CI, 6.7–24.5) in the control group. The postoperative QoR-40 score at 24 hours after surgery did not differ between the 2 groups (BD-TAP group, median [interquartile range], 170.5 [152–178]; control group, 161 [148–175]; median difference, 3 [95% CI, −5 to 13]; P = .427). There were no differences between the 2 groups in the pain dimension of the QoR-40: 30.5 (95% CI, 27–33) in the BD-TAP group and 31 (95% CI, 26–32) in the control group; median difference was 0 (95% CI, −2 to 2); P = .77. CONCLUSIONS: Our results indicate that the BD-TAP block does not improve the quality of recovery or analgesic outcomes following laparoscopic cholecystectomy. Our results do not support the routine use of the BD-TAP block for this surgery....

中文翻译:

双侧肋下加横向腹横肌平面阻滞对腹腔镜胆囊切除术后恢复质量的影响:一项随机安慰剂对照试验

如恢复质量 40 (QoR-40) 所评估,多模式镇痛的 ocks 将提高恢复质量。方法:计划接受择期腹腔镜胆囊切除术的 18 至 60 岁患者随机分为 BD-TAP 组或对照组。BD-TAP组在全麻下采用0.25%罗哌卡因进行BD-TAP阻滞联合多模式镇痛,对照组采用0.9%生理盐水假手术阻滞。两组均采用相同的多模式镇痛方案,包括静脉注射地塞米松、丙乙酰氨基酚、布洛芬和羟考酮。主要结果是术后 24 小时的 QoR-40 评分。使用独立 t 检验、Mann-Whitney U 检验、χ2 检验和 Fisher 精确检验分析数据。结果:每组招募了 38 名患者。BD-TAP 组的平均 QoR-40 得分降低了 13.6(95% 置信区间 [CI],8.3-18.8),对照组降低了 15.6(95% CI,6.7-24.5)。术后 24 小时的术后 QoR-40 评分在两组之间没有差异(BD-TAP 组,中位数 [四分位距],170.5 [152-178];对照组,161 [148-175];中位数差异, 3 [95% CI,-5 到 13];P = .427)。两组在 QoR-40 的疼痛维度上没有差异:BD-TAP 组为 30.5(95% CI,27-33),对照组为 31(95% CI,26-32);中位数差异为 0(95% CI,-2 到 2);P = .77。结论:我们的结果表明 BD-TAP 阻滞不能改善腹腔镜胆囊切除术后的恢复质量或镇痛结果。
更新日期:2021-11-23
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