摘要
目的探讨超声引导下腹横肌平面阻滞在妇科腹腔镜手术的麻醉效果分析。方法入选病例为拟在全身麻醉下行经妇科腹腔镜手术的患者,共40例,年龄区间为35~55岁,ASA分级为I^II级,将40例患者随机分为TAP观察组(T组)和对照组(C组),每组各20例。T组:麻醉前实施TAP阻滞并注入罗哌卡因;对照组(C组):手术结束后行TAP阻滞并注入生理盐水。手术结束后在进行静脉自控镇痛的同时行超声引导下腹横肌平面阻滞。记录并分析两组患者术后各时间点镇痛评分、镇痛效果以及不良反应发生情况。结果T组患者各时间点动态视觉模拟疼痛评分均明显低于C组,两组患者镇痛效果比较T组镇痛泵第一次镇痛按压时间明显晚于C组,镇痛泵按压次数及药物24 h内剂量少于C组,差异具有统计学意义(P<0.05);两组患者不良反应发生情况两组患者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在妇科腹腔镜下手术术后镇痛效果较好。
Objective To explore the analgesic effect of ultrasound guided transversus abdominis plane block in postoperative gynecological laparoscopic surgery.Methods A total of 40 American Society of Anesthesiologists(ASA)grade I^IIpatients with selective cesarean section under combined spinal and epidural anesthesia as studysubjects were randomly divided into group T and group C,with 20 cases in each group.Group T received ropivacaine injection,and group C received equal volume of sodium chloride solution injection.They received patient controlled intravenous analgesia and ultrasound guided transversus abdominis plane block after completion of operation.The analgesic related data and occurrence of adverse reactions in two groups were recorded and analyzed at different times after operation.Results Group T had no statistically significant difference in static visual analogue pain scores at each time point comparing with group C(P>0.05),and obviously lower dynamic visual analogue pain score at each time point than group C.Their difference had statistical significance in group C,less analgesic pump pressing times and 24 h drug dose than group C.Their difference had statistical significance(P<0.05).Conclusions Ultrasound guided transversus abdominis plane block shows good analgesic effect in postoperative cesarean section,and it is worthy of clinical promotion and use.
作者
孙鑫
孙宏丽
安万丰
SUN Xin;SUN Hongli;AN Wanfeng(Department of Anesthesiology,No.242 Hospital,Harbin 150066,Heilongjiang Province)
出处
《航空航天医学杂志》
2020年第5期532-534,共3页
Journal of Aerospace medicine
关键词
超声引导
腹横肌平面阻滞
妇科腹腔镜
镇痛
Ultrasound guidance
transverse abdominal muscle block
gynecological laparoscopy
analgesia