罗哌卡因腹横肌平面阻滞应用于腹腔镜下结肠癌术后镇痛的效果分析

Analgesic Effects of Ropivacaine Transverse Abdominis Plane Block on Patients after Laparoscopic Colon Cancer Surgery

目的观察罗哌卡因腹横肌平面(TAP)阻滞应用于腹腔镜下结肠癌术后的镇痛效果。方法选择全身麻醉下行腹腔镜结肠癌手术的患者64例,ASA分级Ⅰ~Ⅱ级,年龄21~49岁,将其随机分为TAP阻滞组(T组)和对照组(C组),每组32例。常规麻醉诱导、气管插管后行超声引导下双侧TAP阻滞,T组注射0.375%罗哌卡因20 m L,C组注射生理盐水20 m L。两组患者均使用氢吗啡酮静脉自控镇痛(PCIA)维持术后24 h镇痛。应用视觉模拟评分(VAS)量表记录两组患者静息时及运动时的疼痛程度,观察术后并发症及镇痛不良反应的发生情况。结果 T组术后2、4、12、24 h的静息疼痛评分以及术后2、4h的运动疼痛评分显著低于C组(P<0.05)。T组恢复肠道功能的平均时间显著短于C组(P<0.05)。T组平均住院天数较C组明显缩短(P<0.05)。两组术后均无明显不良反应发生。结论罗哌卡因TAP阻滞可显著缓解腹腔镜下结肠癌手术患者的术后疼痛、促进患者早期下床活动、缩短住院时间、加速康复。

Objective To observe the analgesic effects of ropivaeaine for the transverse abdominis plane （TAP） block after laparoseopie colon cancer sm＇gery. Methods A total of 64 patients with laparoscopic colon cancer surgery had general anesthesia. Patients were ran- domized into two groups to receive either TAP block using 20 mL of 0.375% ropivacaine （group T： 32 patients） or 20 mL of 0.9% normal saline infusion （group C： 32 patients）. Patients in both groups got patient-controlled intravenous analgesia （PCIA） with hydromorphone to maintain analgesia 24 hours after surgery. The visual analogue scale （VAS） was used to record the pain of both groups at rest and during movement. The postoperative complications and analgesic adverse reactions were observed and compared. Results The group T had lower pain scores after operation at 2 h, 4 h, and 12 h at rest and at 2 h and 4 h dining movement than group C （P〈 0.05）. The mean time to restore intestinal function in group T was shorter than that in group C （P〈0.05）. The mean length of hospital stay in group T was shorter than that in group C （P 〈 0.05）. There were no significant adverse reactions in both groups after operation. Conclusion Ropivaeaine TAP block can significantly alleviate postoperative pain of patients with laparoseopie colon cancer surgery, promote early ambulation, shorten hospital stay, and accelerate recovery.