超声引导下后入路腹横肌平面阻滞联合帕瑞昔布钠在妇科腹腔镜日间手术快速康复中的应用

Ultrasound-guided Posterior Approach TAPB combined with Special Resistance in the Rapid Rehabilitation of Gynecological Laparoscopic Day Surgery

目的探讨超声引导下后入路腹横肌平面阻滞(TAPB)联合帕瑞昔布钠在妇科腹腔镜日间手术快速康复中的应用。方法选择200例在本院行妇科腹腔镜日间手术患者,随机分为对照组(A组,100例)与观察组(B组,100例)。B组在喉罩全麻诱导前给予静脉注射帕瑞昔布钠40 mg,喉罩置入后在超声引导下以0.25%罗哌卡因20 mL行双侧后入路TAPB,术毕30 min前静脉注射帕瑞昔布钠40 mg。结果①拔除喉罩时间B组明显短于A组(P<0.05)。②B组术后各时间点的VAS评分均明显低于A组(P<0.05)。③B组术后盐酸纳布啡使用剂量,延迟出院例数,及恶心、呕吐等不良反应发生例数均明显少于A组(P<0.05)。结论超声引导下后入路TAPB联合帕瑞昔布钠有利于妇科腹腔镜日间手术快速康复。

Objective To investigate the application of ultrasound-guided posterior approach TABP combined with special resistance in gynecological laparoscopic day surgery.Methods A total of 200 patients undergoing gynecologic laparoscopic day surgery in our hospital were randomly divided into the control group(group A,100 cases)and the observation group(group B,100 cases).Group B was given 40 mg of statin(parecoxib sodium)before induction of general anesthesia in the laryngeal mask.After induction,the bilateral posterior approach TAPB was performed with 0.25%ropivacaine 20 mL under ultrasound guidance.Give 40 mg of special resistance.Results(1)The time of removal of the laryngeal mask was significantly lower in group B than in group A(P<0.05).(2)The VAS scores of the group B were significantly lower than those of the A group(P<0.05).(3)The dose of nalbuphine hydrochloride in the group B,the number of delayed discharge,and the number of adverse reactions such as nausea and vomiting were significantly lower than those in group A(P<0.05).Conclusion Ultrasound-guided posterior approach TAPB combined with special resistance is beneficial to the rapid recovery of gynecological laparoscopic day surgery,which is worthy of clinical application.