医学
麻醉
止痛药
曲马多
术后恶心呕吐
随机对照试验
安慰剂
外科
腹部外科
恶心
病理
替代医学
作者
Isabelle Maquoi,Jean Joris,Caroline Dresse,Sofia Vandenbosch,Ingrid Venneman,Jean-François Brichant,Grégory Hans
摘要
Background and Objectives Transversus abdominis plane block (TAP) and intravenous lignocaine are two analgesic techniques frequently used after abdominal surgery. We hypothesized that these two techniques improve post‐operative analgesia after open prostate surgery and sought to compare their efficacy on immediate post‐operative outcome after open prostate surgery. Methods After ethics committee approval, 101 patients were enrolled in this prospective study and randomly allocated to receive bilateral ultrasound‐guided TAP ( n = 34), intravenous lignocaine ( n = 33) or placebo ( n = 34). In addition, intravenous paracetamol was given every 6 h. The primary endpoint was the cumulative opioid consumption during the first 48 post‐operative hours (median[IQR]). Secondary endpoints included pain scores at rest and upon coughing, need for rescue tramadol, incidence of post‐operative nausea and vomiting (PONV), recovery of bowel function and incidence of bladder catheter‐related discomfort. Results Cumulative piritramide consumption after 48 h was 28 [23] mg in the control group, 21 [29] mg in the TAP group and 21 [31] mg in the lignocaine group ( P = 0.065). There was no significant difference in post‐operative pain scores between groups. The proportions of patients requiring rescue tramadol, experiencing PONV or bladder catheter‐related discomfort were similar in each group. Recovery of bowel function was also similar in the three groups. Conclusions Our study suggests that TAP block and intravenous lignocaine do not improve the post‐operative analgesia provided by systematic administration of paracetamol after open prostatectomy.
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