■在小儿下腹部的全身麻醉中,通常使用尾阻滞和腹横肌平面阻滞(TAP)。腹股沟,和泌尿生殖系统手术.直接比较这些技术对回收的影响的数据有限。在这个荟萃分析中,我们比较了这两种技术的术后镇痛持续时间.
■本综述研究了全麻诱导后接受尾部或TAP阻滞手术的儿科患者(0-18岁)的镇痛持续时间。主要结果是镇痛持续时间,定义为第一次抢救镇痛剂量的时间。次要结果包括抢救镇痛药剂量的数量,术后24小时内对乙酰氨基酚的使用,24h疼痛评分曲线下面积,术后恶心呕吐。
■我们系统地搜索了Pubmed,中央,EMBASE,CINAHL,谷歌学者,WebofScience引文索引,美国临床试验注册,以及2020-2022年著名麻醉会议的随机对照试验摘要,这些试验比较了这些阻滞并报告了镇痛持续时间。
■确定了12个RCT,包括825名患者。TAP阻滞与较长的镇痛持续时间相关(平均差异=1.76h,95%CI:0.70-2.81,p=0.001)和24小时内减少的抢救镇痛药剂量(平均差异=0.50剂量,95%CI:0.02-0.98,p=0.04)。在其他结果中没有发现统计学上的显著差异。
■这项荟萃分析表明,TAP阻滞比小儿手术后的尾阻滞提供更长的镇痛持续时间。TAP阻滞还与最初24小时内较少的补救镇痛药剂量相关,而疼痛评分没有增加。
■https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=380876,标识符:CRD42022380876。
UNASSIGNED: The caudal block and transversus abdominis plane block (TAP) are commonly used in combination with general anesthesia for pediatric lower abdominal, inguinal, and genitourinary surgeries. There is limited data directly comparing the impact of these techniques on recovery. In this meta-analysis, we compare the duration of postoperative analgesia between these two techniques.
UNASSIGNED: This review examined the duration of analgesia in pediatric patients (age 0-18 years) undergoing surgery who received caudal or TAP block after induction of general anesthesia. The primary outcome was duration of analgesia, defined as the time to first rescue analgesic dose. Secondary outcomes included number of rescue analgesic doses, acetaminophen usage within 24 h postoperatively, 24 h pain score area under the curve, and postoperative nausea and vomiting.
UNASSIGNED: We systematically searched Pubmed, Central, EMBASE, CINAHL, Google Scholar, Web of Science citation index, the US clinical trials register, and abstracts from prominent 2020-2022 anesthesia conferences for randomized controlled trials that compared these blocks and reported analgesia duration.
UNASSIGNED: Twelve RCTs inclusive of 825 patients were identified. TAP block was associated with longer analgesia duration (Mean difference = 1.76 h, 95% CI: 0.70-2.81, p = 0.001) and reduced doses of rescue analgesic within 24 h (Mean difference = 0.50 doses, 95% CI: 0.02-0.98, p = 0.04). No statistically significant differences were detected in other outcomes.
UNASSIGNED: This meta-analysis suggests that TAP block provides greater duration of analgesia than caudal block after pediatric surgeries. TAP block was also associated with fewer rescue analgesic doses in the first 24 h without increased pain scores.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=380876, identifier: CRD42022380876.