Полный текст статьи доступен для этого языка: Английский.
Аннотация
ВВЕДЕНИЕ: Умеренная или сильная боль после гинекологических операций влияет на послеоперационное восстановление и мобилизацию. Блокада поперечной плоскости живота (TAP-блок) и межфасциальная блокада мышцы, выпрямляющей спину (ESP-блок), использовались в качестве мультимодальной анальгезии при абдоминальной хирургии. ЦЕЛЬ: Целью данного исследования является сравнение послеоперационной боли у пациенток, перенесших либо ESP-блок, либо TAP-блок, и потребность в послеоперационном морфине у пациенток, перенесших гинекологическую операцию. МАТЕРИАЛЫ И МЕТОДЫ: Одноцентровое проспективное двухгрупповое сравнительное исследование. В исследование вошли 40 субъектов, разделенных на две группы. В одной группе применяли ESP-блок (n = 20), у остальных 20 пациенток применяли TAP-блок после гинекологической операции. Интенсивность боли оценивали по числовой рейтинговой шкале (ЧРШ) оценки боли в интервалах 0–1 ч, 1–6 ч, 6–12 ч и 12–24 ч. Статистический анализ проводился с использованием непарного T-критерия для нормально распределенных данных и теста Манна–Уитни для ненормально распределенных данных. Категориальный анализ данных проводился с использованием точного критерия Фишера. РЕЗУЛЬТАТЫ: Оценка ЧРШ в состоянии покоя была выше в группе TAP-блока через 1–6 ч и 6–12 ч (оценка боли — 3 балла), чем в группе блокады ESP-блока (оценка боли — 1 балл). Оценка по ЧРШ боли, вызванной движением, была значительно выше в группах TAP-блока. ВЫВОД: ESP-блокада приводит к более низкому значению оценки послеоперационной боли по ЧРШ и снижает потребность в морфине у пациентов после гинекологических операций со срединным разрезом по сравнению с TAP-блоком.
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