PDF(Pubmed)
Abstract：
UNASSIGNED: In the postoperative period, open total abdominal hysterectomy (TAH) surgeries induce considerable pain. Multimodal strategies are being used to alleviate pain.
UNASSIGNED: This study aimed to examine the efficacy and safety of dexamethasone and dexmedetomidine as an adjuvant to levobupivacaine in ultrasound-guided transversus abdominis plane (TAP) blocks for postoperative pain in TAH patients.
UNASSIGNED: A total of 72 patients with ASA grade I and grade II were randomly and equally assigned to two groups. After the completion of surgery with a subarachnoid block (SAB), patients in group 1 received a mixture of 20 mL of 0.25% levobupivacaine and 4 mg of dexamethasone on each side of the TAP block. Patients in group 2 received a mixture of 20 mL of 0.25% levobupivacaine and dexmedetomidine, with a total dose of 1 µg/kg body weight evenly distributed bilaterally in the TAP block. Patients were evaluated for pain using the Visual Analog Scale (VAS), total tramadol consumption as rescue analgesia, time to first rescue analgesia, any adverse effects, and patient satisfaction.
UNASSIGNED: When comparing VAS scores for pain assessment, we observed that the mean VAS score was initially comparable between the two groups for the first hour. However, at 6, 9, and 12 h, VAS scores were significantly lower in group 2. The mean total tramadol consumption was higher in group 1 than in group 2 (213.33 ± 44.08 vs 161.11 ± 37.93 mg, P-value 0.027). The time to the first rescue analgesia after the TAP block in the postoperative period was significantly longer in group 2 (47.5 ± 62.76 vs 77.22 ± 56.14 min, P-value 0.002). No significant side effects were noted, and a greater proportion of patients in group 2 expressed satisfaction with their overall pain treatment.
UNASSIGNED: The addition of dexmedetomidine to levobupivacaine is superior to the addition of dexamethasone, as it prolongs the duration of the block in the dexmedetomidine group. However, the use of dexamethasone as an adjuvant is a good alternative option, particularly due to its lower cost and reduced incidence of adverse effects such as postoperative nausea and vomiting.
UNASSIGNED: This study aimed to examine the efficacy and safety of dexamethasone and dexmedetomidine as an adjuvant to levobupivacaine in ultrasound-guided transversus abdominis plane (TAP) blocks for postoperative pain in TAH patients.
UNASSIGNED: A total of 72 patients with ASA grade I and grade II were randomly and equally assigned to two groups. After the completion of surgery with a subarachnoid block (SAB), patients in group 1 received a mixture of 20 mL of 0.25% levobupivacaine and 4 mg of dexamethasone on each side of the TAP block. Patients in group 2 received a mixture of 20 mL of 0.25% levobupivacaine and dexmedetomidine, with a total dose of 1 µg/kg body weight evenly distributed bilaterally in the TAP block. Patients were evaluated for pain using the Visual Analog Scale (VAS), total tramadol consumption as rescue analgesia, time to first rescue analgesia, any adverse effects, and patient satisfaction.
UNASSIGNED: When comparing VAS scores for pain assessment, we observed that the mean VAS score was initially comparable between the two groups for the first hour. However, at 6, 9, and 12 h, VAS scores were significantly lower in group 2. The mean total tramadol consumption was higher in group 1 than in group 2 (213.33 ± 44.08 vs 161.11 ± 37.93 mg, P-value 0.027). The time to the first rescue analgesia after the TAP block in the postoperative period was significantly longer in group 2 (47.5 ± 62.76 vs 77.22 ± 56.14 min, P-value 0.002). No significant side effects were noted, and a greater proportion of patients in group 2 expressed satisfaction with their overall pain treatment.
UNASSIGNED: The addition of dexmedetomidine to levobupivacaine is superior to the addition of dexamethasone, as it prolongs the duration of the block in the dexmedetomidine group. However, the use of dexamethasone as an adjuvant is a good alternative option, particularly due to its lower cost and reduced incidence of adverse effects such as postoperative nausea and vomiting.
摘要：
■在术后期间，开腹全子宫切除术（TAH）手术会引起相当大的疼痛。多模式策略被用来减轻疼痛。
■本研究旨在探讨地塞米松和右美托咪定作为左旋布比卡因辅助治疗超声引导下腹横肌平面(TAP)阻滞治疗TAH患者术后疼痛的有效性和安全性。
■将72例ASAI级和II级患者随机平均分为两组。蛛网膜下腔阻滞（SAB）手术完成后，第1组患者在TAP阻滞两侧分别接受20mL左旋布比卡因和4mg地塞米松的混合物.第2组患者接受了20mL的0.25％左旋布比卡因和右美托咪定的混合物，总剂量为1µg/kg体重，在TAP块中两侧均匀分布。使用视觉模拟量表（VAS）评估患者的疼痛，曲马多总消耗量作为抢救镇痛，第一次抢救镇痛的时间，任何不利影响，患者满意度。
■比较疼痛评估的VAS评分时，我们观察到,在最初的第一个小时,两组之间的平均VAS评分是相当的.然而,在6、9和12小时，第2组VAS评分明显降低。第1组平均曲马多总消耗量高于第2组（213.33±44.08vs161.11±37.93mg，P值0.027)。第2组术后TAP阻滞后首次抢救镇痛时间明显延长(47.5±62.76vs77.22±56.14min,P值0.002)。没有发现明显的副作用，第2组患者对整体疼痛治疗表示满意的比例更高.
■在左布比卡因中添加右美托咪定优于添加地塞米松，因为它延长了右美托咪定组的阻滞持续时间。然而,使用地塞米松作为佐剂是一个很好的替代选择，特别是由于其成本较低，减少了术后恶心和呕吐等不良反应的发生率。
■本研究旨在探讨地塞米松和右美托咪定作为左旋布比卡因辅助治疗超声引导下腹横肌平面(TAP)阻滞治疗TAH患者术后疼痛的有效性和安全性。
■将72例ASAI级和II级患者随机平均分为两组。蛛网膜下腔阻滞（SAB）手术完成后，第1组患者在TAP阻滞两侧分别接受20mL左旋布比卡因和4mg地塞米松的混合物.第2组患者接受了20mL的0.25％左旋布比卡因和右美托咪定的混合物，总剂量为1µg/kg体重，在TAP块中两侧均匀分布。使用视觉模拟量表（VAS）评估患者的疼痛，曲马多总消耗量作为抢救镇痛，第一次抢救镇痛的时间，任何不利影响，患者满意度。
■比较疼痛评估的VAS评分时，我们观察到,在最初的第一个小时,两组之间的平均VAS评分是相当的.然而,在6、9和12小时，第2组VAS评分明显降低。第1组平均曲马多总消耗量高于第2组（213.33±44.08vs161.11±37.93mg，P值0.027)。第2组术后TAP阻滞后首次抢救镇痛时间明显延长(47.5±62.76vs77.22±56.14min,P值0.002)。没有发现明显的副作用，第2组患者对整体疼痛治疗表示满意的比例更高.
■在左布比卡因中添加右美托咪定优于添加地塞米松，因为它延长了右美托咪定组的阻滞持续时间。然而,使用地塞米松作为佐剂是一个很好的替代选择，特别是由于其成本较低，减少了术后恶心和呕吐等不良反应的发生率。
