腹横肌平面阻滞复合全身麻醉对妇科腹腔镜手术患者术后早期恢复和镇痛的影响

Effects of abdominal transverse muscle plane block combined with general anesthesia on early recovery and analgesia in patients undergoing gynecological laparoscopic surgery

目的探讨妇科腹腔镜手术患者联合应用全身麻醉、腹横肌平面阻滞对其术后早期恢复、镇痛影响的价值.方法选取2018年1月至2019年12月粤北人民医院90例妇科腹腔镜手术患者,分为对照组与研究组,每组45例.两组均因妇科疾病需于全身麻醉下接受腹腔镜手术治疗,研究组于全身麻醉诱导后在超声引导下完成双侧腹横肌平面阻滞,对照组仅行全身麻醉.结果研究组术后肠鸣音恢复时间、术后首次肛门排气时间、术后首次下床时间等均少于对照组(P均<0.05);研究组术后2h、术后1dVAS法评分均少于对照组(P均<0.05),两组术后3dVAS法评分比较,差异未见统计学意义(P>0.05).结论妇科腹腔镜手术患者应用腹横肌平面阻滞复合全身麻醉有利于促进其术后早期恢复,且镇痛作用良好.

Objective To investigate the effects of combined general anesthesia and horizontal abdominal muscle block on early recovery and analgesia in patients undergoing gynecological laparoscopic surgery. Methods Ninety cases of gynecological laparoscopic surgery in the Northern Guangdong People's Hospital from January 2018 to December 2019 were selected. They were divided into control group and research group, with 45 cases in each group. Both groups were required to undergo laparoscopic surgery under general anesthesia for gynecological diseases. After induction of general anesthesia, the study group completed bilateral transverse abdominal planar block under ultrasound guidance, while the control group only received general anesthesia. Results The recovery time of intestinal sound, the first anal exhaust time and the first time out of bed after operation in the study group were significantly shorter than those in the control group ( P<0. 05 ). And the 1 d visual analogue scale ( VAS) scores in the study group 2 hours after operation were significantly lower than those in the control group ( P all<0. 05 ). There was no significant difference in VAS score between the two groups 3 day after operation ( P all>0. 05 ). Conclusions The application of abdominal transverse muscle plane block combined with general anesthesia for gynecological laparoscopic surgery is helpful to promote the early recovery and has good analgesic effects.