超声引导肋下斜入路腹横肌平面阻滞对腹部手术术后静脉PCA镇痛的影响

Effect of ultrasound-guided oblique subcostal transversus abdominis plane block on postoperative analgesia in patients underwent abdominal surgery

目的探讨超声引导肋下斜入路腹横肌平面(TAP)阻滞对外科开腹手术患者术后静脉患者自控镇痛(PCA)镇痛效果的影响。方法全身麻醉下择期行腹部手术患者60例随机均分为两组:B组术后使用静脉PCA;A组在此基础上加用双侧TAP阻滞,每侧分别注入0.375%罗哌卡因20ml。比较两组术后2、24和48h的VAS疼痛评分以及镇痛期间不良反应发生情况。结果与B组相比,A组术后24和48h的VAS疼痛评分降低(P<0.05)。两组术后均无明显不良反应发生。结论肋下TAP阻滞能提高开腹手术患者术后PCA镇痛效果。

Objective To investigate the effect of ultrasound-guided oblique subcostal transversus abdominis plane（TAP）block on postoperative intravenous patient-controlled analgesia（PCA）in the patients underwent abdominal surgery.Methods Sixty patients undergoing abdominal surgery under general anesthesia were equally randomized into two groups.The patients in group B received intravenous PCA after surgery and those in group A were given additional bilateral oblique subcostal TAP block with 0.375% ropivacaine 20 ml each side.The efficacy of postoperative analgesia was evaluated by VAS pain scoring at 2,24 and 48 hours after surgery.The adverse responses during analgesia were recorded.Results Compared with group B,VAS pain scores at 24 and 48 hours after surgery were lower in group A（P〈0.05）.No obvious adverse responses were seen in both groups.Conclusion Ultrasound-guided oblique subcostal TAP block can improve postoperative intravenous PCA in the patients undergoing abdominal surgery.