背景:横向腹部计划阻滞(TAP)是在临床实践中迅速扩散的腹壁阻滞,作为腹部手术多模式镇痛的一部分。超声引导技术的性能降低了潜在的并发症,以及根据所进行的描述和前瞻性研究的新方法,可以在不同的外科手术中利用TAP;然而,随机临床试验(RCT)的结果不一致.
目的:准备一项系统综述,旨在确定超声引导下TAP对不同手术干预的疗效,以及根据方法及其影响的适应症。
方法:两种研究方法,一个手册,另一个在Pubmed中返回了28个RCT,其中进行了超声引导的TAP干预,以比较与另一种成人技术相比的镇痛效果,2007年至2013年10月出版,英文或西班牙文,根据本综述的纳入标准,Jadad评分>1。作者独立分析了所有RCT。
结论:TAP已被证明是结直肠手术的有效技术,剖宫产,胆囊切除术,子宫切除术,阑尾切除术,供体肾切除术,耻骨后前列腺切除术,和减肥手术。然而,在RCT中发现的数据并不是决定性的,结果,有必要开发新的和精心设计的RCT,有足够的统计能力来比较不同的方法,毒品,剂量,相同干预的数量,旨在回答当前的问题及其在习惯性临床实践中的作用。
BACKGROUND: The transverse abdominal plan blockade (TAP) is a block of abdominal wall that has diffused rapidly in the clinical practice as part of a multimodal analgesia for abdominal surgery. The performance of the ultrasound-guided technique has allowed the lowering of potential complications, as well as new approaches that according to the descriptions carried out and the prospective studies would make it possible to utilize the TAP in different surgical interventions; however, the results obtained in randomized clinical trials (RCTs) are inconsistent.
OBJECTIVE: To prepare a systematic
review aiming to determine the efficacy of the ultrasound-guided TAP for different surgical interventions, as well as the indications according to the approaches and their influences.
METHODS: Two research approaches, one manual, and the other in Pubmed returned 28 RCT where an intervention with ultrasound-guided TAP were performed to compare the analgesic efficacy in contrast to another technique in adults, published between 2007 and October 2013, in English or Spanish, with Jadad score > 1, according to the inclusion criteria for this
review. The authors analyzed independently all the RCT.
CONCLUSIONS: The TAP have been shown to be an effective technique in colorectal surgery, cesarean section, cholecystectomy, hysterectomy, appendectomy, donor nephrectomy, retropubic prostatectomy, and bariatric surgery. However, the data found in RCT are not conclusive, and as a result, it is necessary to develop new and well designed RCT, with enough statistical power to compare different approaches, drugs, doses, and volumes for the same intervention, aiming to answer the current questions and their effects in the habitual clinical practice.