原著論文
腹腔鏡下子宮全摘術における術後鎮痛法に関する検討（末梢神経ブロック法 vs 硬膜外自己調節鎮痛法）
キーワード:
rectus sheath block,
transversus abdominis plane block,
patient-controlled epidural anesthesia
2018 年 34 巻 1 号 p. 62-69
詳細
2018 年 34 巻 1 号 p. 62-69
Objective: The objective of this clinical study was to compare abdominal field block to patient-controlled epidural analgesia (PCEA) after total laparoscopic hysterectomy (TLH).
Methods: Forty patients who underwent TLH at our hospital from July to September 2015 and from September 2016 to January 2017 were divided into two groups. The patients in group A received rectus sheath and transversus abdominis plane block, and those in group B received PCEA. Post-operative pain was followed for 2 days after surgery and evaluated using a visual analog scale (VAS) at rest and during activity. The frequency of analgesic use was also monitored.
Results: VAS scores at rest in group A were significantly higher than those in group B at 6 hours and 2 days after surgery.
VAS scores during activity in group A were significantly higher at all time points (6 hours, 1 day, and 2 days after surgery). However, there were no significant differences in VAS scores at rest between the two groups at 1 hour, 3 hours, and 1 day after surgery.
The patients in group A required significantly more analgesics than those in group B.
Conclusion: Abdominal field block after TLH seems less effective compared to PCEA, especially during activity after surgery.
