为了评估腹直肌横切面（TAP）阻滞对妇科恶性肿瘤腹腔手术后结果的影响，本回顾性队列研究评估了2016年至2017年和2020年在加拿大阿尔伯塔省接受腹腔手术的患者。主要结果指标为口服吗啡吗啡当量（MME）的阿片类药物使用量。次要结果指标包括最大疼痛评分、住院时间和患者自控镇痛（PCA）使用情况。采用t检验进行结果比较，并通过非甾体抗炎药（NSAID）使用进行亚组分析。进行多元回归分析以排除潜在混杂因素。 共收集956名患者的数据，其中828名接受了TAP阻滞，128名未接受。TAP阻滞组患者在首个24小时使用的阿片类药物较少（35.9 mg MME vs 44.5 mg MME，p = 0.0294），并未增加疼痛评分，但在回归分析后该差异不显著。接受TAP阻滞的患者的平均住院时间（3.2天 vs 5.0天，p < 0.0001）和PCA使用率（19.9% vs 56.25%，p < 0.0001）显著减少。在未接受NSAID治疗的患者亚组分析中（n = 160），与未接受TAP阻滞的患者相比，接受TAP阻滞的患者在首个24小时内的平均阿片类药物使用量减少（36.1 mg vs 61.2 mg，p = 0.0017），并且在24至48小时内的使用量也减少（16.3 mg vs 51.0 mg，p < 0.0001）。 外科医生执行的TAP阻滞与未接受预定NSAID治疗的患者的住院时间减少和术后阿片类药物使用减少相关。这种阿片类药物使用的减少没有与平均疼痛评分或最大疼痛评分的增加相关。 版权所有 © 2023 作者。由Elsevier Inc.出版。保留所有权利。

To characterize the effect of transversus abdominis plane (TAP) blocks on post-operative outcomes in patients undergoing laparotomy for gynecologic malignancy.This retrospective cohort study assessed patients undergoing laparotomy in 2016-2017 and 2020 in Alberta, Canada. The primary outcome was opioid consumption in oral morphine milligram equivalent (MME). Secondary outcomes included maximum pain scores, length of stay, and patient-controlled analgesia (PCA) use. Outcomes were compared using t-test with subgroup analysis by NSAID use. Multivariate regression modelling was performed for potential confounders.Data was collected on 956 patients; 828 received a TAP block, 128 did not. Opioid use in the first 24 h was lower in the TAP block group (35.9 mg MME vs 44.5 mg MME, p = 0.0294), without any increase in pain scores, this did not remain significant after regression analysis. Patients with TAP blocks had significant reduced mean length of stay (3.2 days vs. 5.0 days, p < 0.0001), and PCA use (19.9% vs. 56.25%, p < 0.0001). On subgroup analysis of patients that did not receive NSAIDs (n = 160), mean opioid use was decreased in those patients with TAP blocks compared to those without TAP blocks in the first 24 h (36.1 mg vs. 61.2 mg, p = 0.0017), and at 24 to 48 h (16.3 mg vs. 51.0 mg, p < 0.0001).Surgeon-administered TAP blocks were associated with decreased length of stay and post-operative opioid use in patients not receiving scheduled NSAIDs. This decrease in opioid use was not associated with any increase in average or maximum pain scores.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.