2% lidocaine을 사용한 초음파 유도 배가로근면 차단이 하복부 수술 후 초기 통증 조절에 미치는 영향 (The analgesic efficacy of ultrasound-guided transversus abdominis plane block with 2% lidocaine in early postoperative period after lower abdominal surgery)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Anesthesia and Pain Medicine / 7권 / 4호 / 280 ~ 285페이지
· 저자명 : 송인경, 김치효, 한종인, 이귀용, 정락경, 백희정, 김세희

초록

Background: Transversus abdominis plane (TAP) block is a new regional anesthetic technique for postoperative pain control after lower abdominal surgery. We evaluated the analgesic efficacy of ultrasound-guided (US-) TAP block in patients undergoing lower abdominal surgery.
Methods: Thirty American Society of Anesthesiologists physical status I or II patients between 20−80 years of age undergoing lower abdominal surgery were randomized to receive standard care (n = 15) including intravenous patient-controlled analgesia (IV-PCA),or to undergo bilateral US-TAP block adjunctively (n = 15). A standard general anesthetic technique was used. After induction of anesthesia, bilateral US-TAP block was performed using total 30ml of 2% lidocaine. Each patient was assessed postoperatively at 20, 30, and 60 min in postanesthesia care unit (PACU) and at 6,12, and 24 h in ward for pain scores using verbal numerical rating scale (VNRS), analgesic requirements, quality of sleep, and complications.
Results: US-TAP block significantly reduced VNRS pain scores at 20, 30, and 60 min postoperatively (P ＜ 0.001). The US-TAP block group required significantly fewer remifentanil intraoperatively (P ＜ 0.05). Additional analgesic requirements were significantly lower in both PACU and ward (P ＜ 0.05) in the US-TAP block group. There were no statistically significant between-group differences in total infused volume of IV-PCA, time to first requirement of analgesics in ward, and quality of sleep.
Conclusions: US-TAP block with 2% lidocaine provided superior analgesia after lower abdominal surgery especially in the first 60postoperative min when used as a component of a multimodal analgesic regimen.

영어초록

Background: Transversus abdominis plane (TAP) block is a new regional anesthetic technique for postoperative pain control after lower abdominal surgery. We evaluated the analgesic efficacy of ultrasound-guided (US-) TAP block in patients undergoing lower abdominal surgery.
Methods: Thirty American Society of Anesthesiologists physical status I or II patients between 20−80 years of age undergoing lower abdominal surgery were randomized to receive standard care (n = 15) including intravenous patient-controlled analgesia (IV-PCA),or to undergo bilateral US-TAP block adjunctively (n = 15). A standard general anesthetic technique was used. After induction of anesthesia, bilateral US-TAP block was performed using total 30ml of 2% lidocaine. Each patient was assessed postoperatively at 20, 30, and 60 min in postanesthesia care unit (PACU) and at 6,12, and 24 h in ward for pain scores using verbal numerical rating scale (VNRS), analgesic requirements, quality of sleep, and complications.
Results: US-TAP block significantly reduced VNRS pain scores at 20, 30, and 60 min postoperatively (P ＜ 0.001). The US-TAP block group required significantly fewer remifentanil intraoperatively (P ＜ 0.05). Additional analgesic requirements were significantly lower in both PACU and ward (P ＜ 0.05) in the US-TAP block group. There were no statistically significant between-group differences in total infused volume of IV-PCA, time to first requirement of analgesics in ward, and quality of sleep.
Conclusions: US-TAP block with 2% lidocaine provided superior analgesia after lower abdominal surgery especially in the first 60postoperative min when used as a component of a multimodal analgesic regimen.

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