Liposomal bupivacaine in transversus abdominis plane blocks for lower abdominal surgery.
Liposomal bupivacaine in transversus abdominis plane blocks for lower abdominal surgery.
复制标题
脂质体布比卡因在腹横肌平面块中用于下腹部手术。
DOI：
10.1111/papr.13347
复制
发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Quaye,Aurora
中科院分区：
文献类型：
--
作者：
Osuchukwu,Obiyo;Gagnon,James;Richard,Janelle;Craig,Wendy;Quaye,Aurora
研究背景腹横肌平面阻滞是腹盆手术术后镇痛的常用方法。布比卡因脂质体是布比卡因的一种缓释制剂，可提供长达72小时的镇痛。本研究旨在确定是否与脂质体布比卡因进行腹横肌平面阻滞与减少阿片类药物的消耗和水平的疼痛强度相比，传统的布比卡因在接受下腹部surgery.MethodsThis回顾性队列研究是在一个单一的机构2020年12月和2021年12月之间进行。在机构审查委员会批准后，我们确定了接受下腹部骨盆手术的患者，这些患者使用脂质体或常规布比卡因进行腹横肌平面阻滞，并收集人口统计学、临床和手术信息进行分析。我们比较了术后72小时内阿片类药物的总消耗量，包括毫克吗啡当量（MME）、阿片类药物使用频率和组间疼痛强度的平均水平。在调整协变量后，还对这些结局进行了评价。数据以平均值±标准差，中位数[IQR]或频率（%），视情况而定;p< 0.05被接受为significant.ResultsA共178例患者符合纳入标准，其中79例患者接受脂质体布比卡因和常规布比卡因的混合物，99例患者接受常规布比卡因。脂质体布比卡因组术后72小时的阿片类药物中位消耗量为47.5 [18-91.8] MME，而常规布比卡因组为88 [43.8-160] MME，p= 0.045。在调整人口统计学和临床特征后，两组之间阿片类药物消耗的差异未达到统计学显著性，p= 0.11。阿片类药物的使用频率或平均疼痛intensity.Conclusiontransversus腹部平面阻滞使用的混合物的脂质体布比卡因常规布比卡因与阿片类药物的消耗量减少或疼痛减少到72小时后择期abdominopelvic手术没有显着差异。
BackgroundTransversus abdominis plane blocks are an established method of postoperative analgesia for abdominopelvic surgeries. Liposomal bupivacaine is an extended‐release formulation of bupivacaine providing up to 72 h of analgesia. This study aims to determine if transversus abdominis plane blocks performed with liposomal bupivacaine are associated with reduced opioid consumption and level of pain intensity compared to conventional bupivacaine in patients undergoing lower abdominal surgery.MethodsThis retrospective cohort study was conducted at a single institution between December 2020 and December 2021. After institutional review board approval, we identified patients who underwent lower abdominopelvic surgery with transversus abdominis plane blocks done with liposomal or conventional bupivacaine and collected demographic, clinical, and procedural information for analysis. We compared total opioid consumption over 72‐h postoperatively in milligram morphine equivalents (MME), frequency of opioid utilization, and average level of pain intensity between groups. These outcomes were also evaluated after adjusting for covariates. Data were presented as mean ± SD, median [IQR] or frequency (%), as appropriate;p< 0.05 was accepted as significant.ResultsA total of 178 patients met inclusion criteria, with 79 patients receiving an admixture of liposomal bupivacaine and conventional bupivacaine and 99 patients receiving conventional bupivacaine. The liposomal bupivacaine group had a median opioid consumption 72‐h postoperatively of 47.5 [18–91.8] MME compared to 88 [43.8–160] MME in the conventional bupivacaine group,p= 0.045. Differences in opioid consumption between the groups did not reach statistical significance after adjustment for demographic and clinical characteristics,p= 0.11. There was no significant difference in frequency of opioid use or average pain intensity.ConclusionTransversus abdominis plane blocks using an admixture of liposomal bupivacaine conventional bupivacaine are not associated with decreased opioid consumption or reduced pain up to 72 h following elective abdominopelvic surgery.