超声引导双侧腹直肌后鞘联合腹横肌平面阻滞对腹腔镜手术镇痛效果和术后恢复的影响

Effect of ultrasound-guided bilateral posterior rectus sheath block combined with transverse abdominal plane block on analgesia of laparoscopic surgery and postoperative recovery

目的:探讨超声引导下行双侧腹直肌后鞘(PRSB)联合腹横肌平面阻滞(TAPB)对腹部腔腔镜手术镇痛效果及术后恢复的影响。方法:选择行全麻腹腔镜手术的患者90例,ASAⅠ~Ⅱ级,随机均分为3组:PRSB+TAPB组(A组)、TAPB组(B组)及不阻滞组(C组)。A、B组于术前分别在超声引导下行相应区域阻滞。记录3组患者术中术后镇痛指标、围术期舒芬太尼用量、不良反应的发生情况及术后康复指标。结果:A组各镇痛指标优于B、C组(P<0.05);A组围术期舒芬太尼用量小于B、C组(P<0.05);A组不良反应发生率均低于B、C组(P<0.05);A组术后康复指标最优(P<0.05)。结论:PRSB联合TAPB能增强腹腔镜手术术中、术后镇痛效果,减少麻醉性镇痛药用量及降低不良反应发生率。

Objective:To explore the effect of ultrasound-guided bilateral posterior rectus sheath block(PRSB)combined with transverse abdominal plane block(TAPB)on analgesia of laparoscopic surgery and postoperative recovery.Methods:Ninety patients receiving laparoscopic surgery under general anesthesia with ASA Ⅰ-Ⅱ were randomly divided into three groups:PRSB+TAPB group(group A),TAPB group(group B)and non-block group(group C).Group A and B received ultrasound-guided corresponding block before operation.The analgesic indexes,perioperative sufentanil dosage,adverse reactions and postoperative rehabilitation indexes were recorded.Results:The analgesic indexes of group A were better than those of group B and C(P<0.05);the perioperative sufentanil dosage of group A was less than that of group B and C(P<0.05);the adverse reactions of group A were lower than that of group B and C(P<0.05);the postoperative rehabilitation indexes of group A were the best(P<0.05).Conclusion:PRSB combined with TAPB can enhance intraoperative and postoperative analgesia,reduce the dosage of narcotic analgesics and reduce the incidence of adverse reactions.