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首页> 外文期刊>Surgical Endoscopy >Analgesic efficacy of pre-emptive local wound infiltration plus laparoscopic-assisted transversus abdominis plane block versus wound infiltration in patients undergoing laparoscopic colorectal resection: results from a randomized, multicenter, single-blind, non-inferiority trial
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Analgesic efficacy of pre-emptive local wound infiltration plus laparoscopic-assisted transversus abdominis plane block versus wound infiltration in patients undergoing laparoscopic colorectal resection: results from a randomized, multicenter, single-blind, non-inferiority trial

机译：先发制人的局部伤口渗透加上腹腔镜辅助横向腹腔腹腹梗阻与腹腔镜结直肠切除患者的伤口渗透：随机，多中心，单盲，非劣级试验的结果

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Background Transversus abdominis plane (TAP) block is considered a reliable locoregional technique for pain control after laparoscopic colorectal surgery. However, no clear benefit of TAP block over wound infiltration has been demonstrated by the current literature. This multicenter randomized clinical trial tested the non-inferiority of wound infiltration (WI) compared to WI plus laparoscopic-assisted TAP block (L-TAP). Methods All patients with colorectal cancer and diverticular disease scheduled for laparoscopic resection at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust, Verona, Italy and at the Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University, Daegu, Korea, between April 2018 and March 2019 were considered for the trial. Patients were randomly allocated to either the WI group or the WI plus L-TAP group in a 1:1 allocation ratio. In total, 108 patients entered the study and 102 patients were analyzed; 50 patients received WI plus L-TAP and 52 patients received WI. The primary end point was the efficacy in pain control at 6 h measured according to Numeric Rating Scale (NRS). Secondary aims evaluated pain control at 12, 24, 48 and 72 h and other short-term results related to pain management. Results Estimation of pain intensity at 6 h was comparable between the two groups (p = 0.16) with a mean (95% CI) difference in pain scores of 0.94 (- 0.13 to 2.02). No differences in pain scores were observed at other interval times or considering analgesic consumption, return of bowel function, postoperative complications and length of hospital stay. Conclusion This study suggests that adding TAP block to WI does not affect pain control, amount of analgesics and other short-term outcomes.
机译：背景：腹横肌平面（TAP）阻滞被认为是腹腔镜结直肠手术后控制疼痛的可靠局部技术。然而，目前的文献并未证明TAP阻滞对伤口浸润有明显的益处。这项多中心随机临床试验测试了伤口浸润（WI）与WI加腹腔镜辅助TAP阻滞（L-TAP）相比的非劣效性。方法所有的大肠癌和憩室病患者都安排在意大利维罗纳维罗纳大学医院信托和普通肝胆外科分院的腹腔镜手术中，以及在韩国大邱庆北国立大学的庆北国立大学医学中心的结肠直肠癌中心。2018年4月至2019年3月期间，被考虑进行试验。患者被随机分配到WI组或WI+L-TAP组，分配比例为1:1。总共有108名患者进入研究，并对102名患者进行了分析；50名患者接受了WI加L-TAP，52名患者接受了WI。主要终点是根据数字评分量表（NRS）测量的6小时疼痛控制效果。次要目标评估12、24、48和72小时的疼痛控制以及其他与疼痛管理相关的短期结果。结果两组患者对6h疼痛强度的估计具有可比性（p=0.16），疼痛评分的平均差异（95%CI）为0.94（-0.13至2.02）。在其他间隔时间或考虑到止痛药用量、肠功能恢复、术后并发症和住院时间，观察到疼痛评分没有差异。结论本研究表明，在WI中加入TAP阻滞不会影响疼痛控制、止痛药用量和其他短期结果。

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