超声引导下腹横肌平面阻滞技术对腹部手术后镇痛的效果

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

目的观察超声引导下腹横肌平面阻滞技术对腹部手术后镇痛的效果。方法选择64例开腹手术患者,按照随机数字表法分为观察组和对照组,各32例。观察组采用腹横肌平面阻滞(TAPB)+自控静脉镇痛(PCIA)镇痛,对照组行单纯PCIA镇痛。记录2组患者术后清醒拔管即刻(T_0)、2 h(T_1)、6 h(T_2)、12 h(T_3)、24 h(T_4)各时间点的Prince-Henry评分及Ramsay镇静评分。记录穿刺相关并发症及术后各时段镇痛装置按压次数。记录患者满意度及不良反应。结果观察组T_0、T_1、T_2时点Prince-Henry评分明显小于对照组(P<0.05)。2组患者不同时间点的Ramsay镇静评分差异均无统计学意义(P>0.05)。观察组未发生穿刺相关并发症,术后6 h内镇痛泵按压次数明显少于对照组(P<0.05),呕吐发生率明显低于对照组(P<0.05),镇痛满意度高于对照组(P<0.05),差异均有统计学意义。结论超声引导下腹横肌平面阻滞技术可降低腹部手术后6 h内Prince-Henry评分,减少术后镇痛药物的用量及并发症,术后镇痛满意度高。

Objective To investigate the effect of ultrasound - guided transversus abdominis plane block on efficacy of postoperativeanalgesia in patients undergoing abdominal operation. Methods Totally 64 patients undergoing abdominal operation were randomly divided intoobservation group and control group. After sugery,transversus abdominis plane block （ TAPB）and patient - controlled intravenous analgesia（ PCIA）were performed in observation group,control group only received PCIA. The score of Prince - Henry 、 Ramsay sedation score were evaluated at awake extubation （ T0 ） ,2h （ T1 ） ,6h（ T2 ） ,12h（ T3 ） ,24h（ T4 ） after operation. the complication of transversus abdominis planepuncture,the number of press analgesia device each time were recorded. The patient satisfaction and the adverse reactions were also recorded.Results The Prince - Henry score of T0 ,T1 and T2 in the observation group was significantly lower than that in the control group （ P 〈 0 05） .There was no significant difference between the two groups in the Ramsay sedation score at different time points. The observation group had nocomplications related to puncture;observation group 6h postoperative analgesia pressing times were significantly less than that of the controlgroup （ P 〈 0 05） ;the incidence of vomiting was significantly lower than that of the control group （ P 〈 0 05） ;postoperative analgesia satisfaction is higher than that of the control group （ P 〈 0 05） . Conclusion Ultrasound - guided transversus abdominis plane block technique can reduce the Prince - Henry score within Postoperative 6h,reduce the amount of pain medication and side effects of postoperative analgesia,andimprove the postoperative satisfaction.