超声下TAPB联合RSB在减重手术中的应用
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v3i2.4172
Abstract
随着腹腔镜技术和代谢手术的发展,越来越多的肥胖患者接受了代谢手术。腹腔镜胃袖状切除术(LSG)因其相对简单安全的技术和良好的减肥代谢效果而成为最常见的减肥手术。但由于肥胖患者的病理生理改变,术后恶心呕吐、心脏缺血,甚至心肌梗死和呼吸道并发症的风险增加。如何促进术后早期恢复成为临床研究的重点。有研究表明,超声引导下腹横肌平面阻滞(TAPB)和腹直肌鞘阻滞(RSB)可减轻腹部术后疼痛,减少镇痛药物的使用,从而促进患者术后早期恢复[1,2]。然而,TAPB和RSB 在腹腔镜袖状胃切除术中的作用尚无报道。本文就腹横肌平面阻滞和腹直肌鞘阻滞在腹腔镜袖状胃切除术中的应用作一综述。
Keywords
袖状胃切除术；腹横肌平面阻滞；腹直肌鞘阻滞
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[3] MEMBERS OF THE WORKING PARTY, NIGHTINGALE C E, MARGARSON M P,et al. Peri-operative management of the obe se surgical patient 015:association of anaesthetists of great britain and ireland society for obesity and bariatricanaesthesia[J].Anaesthesia,015,70(7):859-876.
[4] HOU X, LU J, WENG J, et al. Impact of waist circumference and body mass index on risk of cardiom etabolic disorder and cardiovascula r disease in Chinese adults:a natio nal diabetes and metabolic disorders survey[J/OL].PLoSOne,013,8(3):e57319.
[5] Vranešić Bender D,KrznarićZ.Nutritional and behavioral modif ication therapies of obesity:facts and fiction[J].Dig Dis, 01 ,30(6):163-167.
[6] Rebibo L,Maréchal V,De Lameth I,et al.Compliance with a multidisci plinary team meeting’s decision pri or to bariatric surgery protects against major postoperative compli cations[J].Surg Obes Relat Dis,017,13(9):1537-1543.
[7] Schauer PR,Bhatt DL,Kashyap SR.Bariatric surgery or intensive medical therapy for diabetes after 5 years[J].N Engl J Med, 017,376(10):1997.
[8] Helmiö M,Victorzon M,Ovaska J,et al.Comparison of short-term outcome of laparoscopic sleeve gast rectomy and gastric bypass in the treatment of morbid obesity:A prosp ective randomized controlled multi center SLEEVEPASS study with 6-month follow-up[J].Scand J Surg, 014,103(3):175-181.
[9] Steele KE, Prokopowicz GP, Chang HY,et al.Risk of complications after bariatric surgery among indiv iduals with and without type diabet es mellitus[J].Surg Obes Relat Dis, 01,8(3):305-330.
[10] Siyam M, Benhamou D.Anaesth etic management of adult patients with obstructive sleep apnea syndr ome[J].Ann Fr Anesth Reanim, 007,6 (1):39-5.
[11] Overby DW, Kohn CP, Cahan MA, et al.Prevalence of thrombophilias in patients presenting for bariatric surgery[J].Obes Surg, 019, 19 (9) :1 78-1 85.
[12] Lissauer J, Mancuso K, Merri tt C, et al.Evolution of the transv ersus abdominis plane block and its role in postoperative analgesia[J]. Best Pract Res Clin Anaesthesiol, 014,8(2):117-1 6.
[13] Aveline C,Le Hetet H,Le Roux A,et al.Comparison between ultrasou nd-guided transversus abdominis pla ne and conventional ilioinguinal/il iohypogastrie nerve blocks for day ease open inguinal hernia repair[J].Br J Anaesth, 011,106(3):380-386.
[14] Niraj G, Searle A, Mathews M, et al.Anzlgesic efficacy og ultraso und-guided transverses abdominis pl ane block in patients undergoing op en appendicectomy[J].Br J Anaesth 009, 103(4):60-65.
[15] Walter CJ, Maxwell-Armstrong C, Pinkney TD, et al.Arandomized controlled trial of the efficacy of ultrasound-guided transverses abdo minis plane (TAP)block in laparosc opic colorectal surgery[J].Surg End osc,013,7(7):366- 37.
[16] De Oliveira Jr GS, Fitzgera ld PC, Marcus RJ, et al.A doseranging study of the effect of transverses abdominis block on postoperative quality of recovery and analgesia after outpatient laparoscopy[J].An esth Analg,011,113(5):118-15.
[17] Hebbard P.Subcostal transv erses abdominis plane block under ultrasound guidance[J].Anesth Analg, 008,106(11):674-675.
[18] Kitlik A, Erdoqan MA, Ozqul U, et al.Ultrasound-guided transve rsus abdominis plane block for pos toperative analgesia in living liver donors:A prospective, randomized, double-blinded clinical trial[J]. JClin Anesth,017,37(12):103-107.
[19] FergusonS, ThomasV, LewisI. The rectus sheath block in paediat ric anaesthesia: new indications for an old technique?[J]. Paediatr Anaes th,1996,6(6):463-466.
[20] WillschkeH,BösenbergA,Marh oferP,et al. Ultrasonography-guided rectus sheath block in paediatric anaesthesia-a new approach to an old technique[J].Br J Anaesth,006,97 (11):44-49.DOI:10.1093/bja/ael143.
[21] SviggumHP,NiesenAD,SitesBD, et al. Trunk blocks 101: transversus abdominis plane, ilioinguinal-ilioh ypogastric, and rectus sheath block s[J].Int Anesthesiol Clin,01,50(1):74-9.
[22] FinnertyO,CarneyJ,McDonnellJG.Trunkblocks for abdominal surg ery[J].Anaesthesia,010,65(Suppl1):76-83.
[23] Tran TM, Ivanusic JJ, Hebb ard P, et al. Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study[J]. British Journal of Anaesthesia(1):13-17. [24 Murouchi T, Yamauchi M, Gi E, et al.Ultrasound-guided subcostal and mid-axillary transverus abdominis plane block: a cadaveric study of the spread of injectate[J].Masui the Jap anese Journal of Anesthesiology,013.
[24] Bhatia N, Arora S, Jyotsna W, et al. Comparison of posterior and subcostal approaches to ultrasoundguided transverseabdominis plane block for postoperative analgesia in laparoscopic cholecystectomy[J]. Journal of Clinical Anesthesia, 014, 6(4):94- 99.
[25] Bashandy GM, Elkholy AH. Reducing Postoperative Opioid Consump tion by Adding an Ultrasound-Guided Rectus Sheath Block to Multimodal Ana lgesia for Abdominal Cancer Surgery With Midline Incision[J].Anesthesiol ogy & Pain Medicine,014, 4(3):e18 63.
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