超声引导下腹横肌平面阻滞在幼儿腹股沟疝囊高位结扎术中的应用

Application of ultrasound-guided transversus abdominis plane block in high ligation of inguinal hernia sac in children

目的探讨超声引导下腹横肌平面阻滞在幼儿腹股沟疝囊高位结扎术中的应用效果.方法将80例拟行腹股沟疝囊高位结扎术的幼儿腹股沟疝囊患者按随机数字表法分为研究组与对照组各40例,两组均给予全身麻醉,于手术前静脉注射喷他佐辛,研究组在此基础上给予患侧超声引导下腹横肌平面阻滞.比较两组患儿手术时间、术中麻醉药物用量、拔管时间、术后FLACC评分、术后追加镇痛药情况,比较两组不良反应发生情况.结果两组手术时间比较差异无统计学意义(P>0.05),研究组术中麻醉药物用量均显著少于对照组(P<0.01),拔管时间显著短于对照组(P<0.01).研究组术后1h、6h、12h、24hFLACC评分均显著低于对照组(P<0.01),术后追加镇痛药患儿显著少于对照组(P<0.01).两组不良反应发生率比较差异无统计学意义(P>0.05).结论超声引导下腹横肌平面阻滞是一种成熟的区域阻滞技术,适合作为幼儿腹股沟疝囊高位结扎术后的主要镇痛方式,安全性高、镇痛效果好,值得推广应用.

Objective To study the effect of ultrasound-guided transversus abdominis plane block in high ligation of inguinal hernia sac in children.Methods 80 cases of children w ho underwent high ligation of inguinal hernia sac were randomly divided into study group and control group,40 cases in each group. General anesthesia was given to both groups,and pentazocine was given intravenously before surgery.On the basis of this,the study group underwent ultrasound-guided transversus abdominis plane block.The operation time,the intraoperative anesthetic dosage,the ex tubation time,the FLACC score af ter operation,the situation of additional analgesics af ter operation and the occurrence of adverse reactions were compared between the two groups.Results There was no significant difference in the operation time between the two groups ( P>0.05 ).The amount of anesthetic drugs in the study group was significantly lower than that in the control group ( P<0.01 ),and the ex tubation time was significantly shorter than that of the control group ( P<0.01).The FLACC scores of the study group were significantly lower than those of the control group at 1 h,6 h,12 h,and 24 h af ter surgery ( P<0.01 ).The num ber of children with additional analgesics af ter surgery was significantly lower than that of the control group ( P<0.01). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05).Conclusion Ultrasound-guided transversus abdominis plane block is a mature regional block technique that is suitable as the main analgesic method after high ligation of the inguinal hernia sac.It has high safety and good analgesic effect and is worthy of promotion and application.