超声引导腹横肌平面阻滞用于下腹部手术患者术后镇痛效果的观察

Effect of ultrasound-guided transverses abdominis plane block on postoperative analgesia in patients undergoing lower abdominal operation

目的:观察研究超声引导腹横肌平面阻滞对下腹部患者术后镇痛效果。方法:全麻下行下腹部手术患者300例,随机分为罗哌卡因组(A组,n=151)和生理盐水组(B组,n=149)。术后行超声引导双侧作TAP阻滞,分别注射0.375%罗哌卡因20 m L(A组)或等容量生理盐水(B组)。术后观察VAS、Ramsay及BCS评分。记录术后24 h内不良反应的发生情况。结果:两组VAS及Ramsay评分组间比较差异有统计学意义(P<0.05)。与B组比较,24 h内A组VAS评分下降(P<0.05);BCS评分升高(P<0.05);镇静水平未见统计学差异(P>0.05);两组不良反应未见统计学差异(P>0.05)。结论:超声引导TAP阻滞可满足下腹部手术患者术后镇痛需求。

Objective To investigate the influence and safety of uhrasound-guided transverses abdominis plane block on general analgesia in patients undergoing lower abdominal operation. Methods Three hundred patients scheduled for lower abdominal operation under general anesthesia were randomly divided into 2 groups： ropivacaine group （group A,n = 151） and normal saline group （group B,n = 149）. After the operation uhrasound-guided TAP was performed and 0.375% ropivacaine 20 mL was injected in group A while the equal volume of normal saline was used instead in group B. VAS score, Ramsay sedation score, and Bruggrmann comfort scale （BCS） score were recorded at the time points of 2, 4, 6, 8, 12, 24 hours postoperatively. The adverse reactions such as nausea, vomiting, urinary retention, motor and sensory disorders were also recorded. Results No significant difference in the demographic characteristics such as sex, age, height and weight, was observed between the two groups （P 〉 0.05）. VAS score and BCS score were significantly different （P 〈 0.05） in group A compared with group B. There were no significant differences （P 〉 0.05） between the two groups in Ramsay score and adverse reactions. Conclusion Ultrasound-guided TAP block can effectively meet the needs of patients with postoperative analgesia and enhance the comfort after the lower abdominal operation.