超声引导下前路腰方肌阻滞用于腹腔镜妇科手术的镇痛效果

The effect of anterior lumbar muscle block guided by ultrasound on analgesia in laparoscopic gynecologic surgery

目的探究超声引导下前路腰方肌阻滞用于腹腔镜妇科手术的镇痛效果。方法选取2018年1月至2019年12月于本院行腹腔镜手术的100例患者作为研究对象,随机分为观察组与对照组,每组50例。对照组采用单纯全身麻醉,观察组采用腰方肌阻滞联合全身麻醉,麻醉诱导后行腰方肌阻滞,比较两组丙泊酚和瑞芬太尼用量、停药后苏醒时间、拔管时间、术后不同时间静态与动态视觉模拟评分法(VAS)评分、镇痛满意度和不良反应发生情况。结果观察组丙泊酚、瑞芬太尼用量均明显少于对照组(P<0.05);观察组苏醒时间、拔除气管导管时间均明显短于对照组(P<0.05);术后4、8、12、24 h,观察组静态、动态VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率明显低于对照组(P<0.05);观察组镇痛满意度明显高于对照组(P<0.05)。结论超声引导下腰方肌阻滞用于腹腔镜妇科手术镇痛的效果显著,可加快患者全身麻醉后的恢复速度,值得临床推广应用。

Objective To explore the effect of anterior lumbar muscle block guided by ultrasound on analgesia in laparoscopic gynecologic surgery.Methods 100 patients who underwent laparoscopic surgery in our hospital from January 2018 to December 2019 were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated with simple general anesthesia,and the observation group was treated with lumbar muscle block combined with general anesthesia,and quadratus lumbar muscle block was performed after induction of anesthesia.The dosage of propofol and remifentanil,the recovery time after drug with drawal and extubation time,static and dynamic visual analogue scale(VAS)scores at different time after operation,analgesic satisfaction and adverse reactions were compared between the two groups.Results The dosages of propofol and remifentanil in the observation group were significantly lower than those in the control group(P<0.05).The recovery time after drug with drawal and extubation time of the observation group were significantly shorter than those of the control group(P<0.05).At 4,8,12,and 24 h after operation,the static and dynamic VAS scores of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).The analgesic satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion Anterior lumbar muscle block guided has remarkable analgesic effect in laparoscopic gynecological surgery,which can accelerate the recovery rate of patients after general anesthesia and is worthy of clinical application.