超声引导下右美托咪定腹横肌筋膜平面阻滞用于腹腔镜结肠切除术后患者镇痛的效果观察

Effect of ultrasound-guided dexmedetomidine on transabdominal transverse fasciae plane block for postoperative analgesia in patients undergoing laparoscopic colectomy

目的探讨超声引导下右美托咪定腹横肌筋膜平面阻滞用于腹腔镜结肠切除术后患者镇痛的效果。方法选取医院收治的拟行腹腔镜结肠切除术的结肠肿瘤患者80例,随机分为观察组和对照组,每组40例。2组术后均行超声引导下双侧腹横肌平面阻滞,观察组在此基础上加用右美托咪定。比较2组镇痛效果和不良反应发生情况。结果观察组阻滞后1 h、4 h、12 h的VAS评分均低于对照组(P<0.01)。Ramsay镇静评分高于对照组(P<0.01)。观察组术后24 h内舒芬太尼用量、镇痛泵按压次数均少于对照组,住院时间短于对照组(P<0.01)。2组均未见严重不良反应。结论超声引导下右美托咪定腹横肌筋膜平面阻滞用于腹腔镜结肠切除术后患者的镇痛镇静效果明显,可促进患者术后恢复,安全性高,值得临床推广应用。

Objective To investigate the effect of ultrasound-guided dexmedetomidine on transabdominal transverse fasciae plane block for postoperative analgesia in patients undergoing laparoscopic colectomy. Methods A total of 80 patients with colonic tumor undergoing laparoscopic colectomy were randomly divided into the observation group and the control group,40 cases in each group. The 2 groups received ultrasound guided bilateral transverse transversus abdominis plane block. The observation group was given dexmedetomidine on the basis of the control group. The analgesic effect and adverse reactions were compared between the 2 groups. Results The VAS scores of 1 h,4 h and 12 h in the observation group were significantly lower than those in the control group（ P〈0. 01）. The sedation score of Ramsay was significantly higher than that of the control group（ P〈0. 01）. The dosage of sufentanil and the frequency of analgesia pump in the observation group were less than those in the control group after 24 h,and the length of stay in the observation group was shorter than that in the control group（ P〈0. 01）. Conclusion The effect of ultrasound-guided dexmedetomidine on transabdominal transverse fasciae plane block for postoperative analgesia in patients undergoing laparoscopic colectomy is good. It can promote postoperative recovery and safety. It is worthy of clinical application.