腹横肌平面阻滞复合全身麻醉在日间腹腔镜腹股沟斜疝术的应用效果

Effect of Transverse Abdominal Muscle Plane Block Combined with General Anesthesia in Daytime Laparoscopic Indirect Inguinal Hernia Surgery

目的:探究腹横肌平面阻滞(TAPB)复合全身麻醉在日间腹腔镜腹股沟斜疝术中的应用效果。方法:将2019年5月至2020年5月期间内于广州市花都区第二人民医院接受日间腹腔镜腹股沟斜疝术治疗的40例患儿选为研究对象。基于电脑随机抽取法,将其均分为对照组和观察组,每组20例。对照组实施全身麻醉,观察组采用TAPB复合全身麻醉。比较两组患儿的麻醉效果与术后不良反应发生情况。结果:观察组患儿的自主呼吸恢复时间、拔除气管导管时间、丙泊酚及瑞芬太尼使用剂量,术后1 h视觉模拟评分法(VAS)评分均少于对照组,差异具有统计学意义(P<0.05);观察组患儿的术后不良反应发生率为10.0 %,低于对照组的45.0 %,差异具有统计学意义(P<0.05)。结论:在日间腹腔镜腹股沟斜疝术中,应用TAPB复合全身麻醉效果显著,能有效减少术中瑞芬太尼和丙泊酚使用剂量,降低术后不良反应发生率,促进患儿术后恢复,安全性和有效性更高。

Objective To explore the effect of transverse abdominal muscle plane block (TAPB) combined with general anesthesia in daytime laparoscopic indirect inguinal hernia surgery.Methods 40 children who received daytime laparoscopic inguinal hernia in the Huadu District Second People’s Hospital of Guangzhou from May 2019 to May 2020 were selected as the study subjects.All subjects were divided into control group and observation group based on computer random selection method,with20 cases in each group.The control group received general anesthesia,and the observation group received TAPB combined with general anesthesia.The effects of anesthesia and postoperative adverse reactions were compared between the two groups.Results The recovery time of spontaneous breathing,the time of extubation of endotracheal tube,the dosage of propofol and remifentanil,and the score of visual analogue scale (VAS) 1 hour after operation in the observation group were significantly lower than those in the control group (P < 0.05).The incidence of postoperative adverse reactions in the observation group was 10.0%,lower than 45.0% in the control group (P < 0.05).Conclusion In the daytime laparoscopic indirect inguinal hernia surgery,the application of TAPB combined with general anesthesia has significant effect,which can effectively reduce the intraoperative dose of remifentanil and propofol,and reduce the incidence of postoperative adverse reactions.It promotes the postoperative recovery of children,and has higher safety and effectiveness.