经超声引导下腹横肌平面阻滞在全子宫切除联合盆腔淋巴结清扫术中的应用效果观察

Application Effect Observation of Under Ultrasound Guidance Transverse Abdominal Muscle Plane Block in Hysterectomy and Pelvic Lymph Node Dissection

目的:探讨经超声引导下腹横肌平面阻滞在全子宫切除联合盆腔淋巴结清扫术中的应用效果。方法:选取2020年5月-2021年9月于茂名市人民医院行全子宫切除联合盆腔淋巴结清扫术的60例患者为研究对象,根据随机数字表法分为观察组与对照组,各30例。对照组实施常规气管插管全身麻醉,观察组在对照组基础上行超声引导下腹横肌平面阻滞。比较两组术后视觉模拟评分表(VAS)评分、镇痛泵舒芬太尼总用量及有效按压次数、不良反应发生情况。结果:观察组术后2、6、12、24、48 h的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低于对照组,差异有统计学意义(P=0.022)。观察组术后48 h内镇痛泵舒芬太尼总用量及有效按压次数均少于对照组,差异有统计学意义(P=0.032)。结论:腹横肌平面阻滞在全子宫切除联合盆腔淋巴结清扫术中的应用效果显著,可减轻患者术后疼痛程度,减少不良反应发生率,利于患者预后恢复。

Objective:To investigate the application effect of ultrasound-guided transverse abdominal muscle plane block in total hysterectomy and pelvic lymph node dissection.Methods:Sixty patients who underwent total hysterectomy and pelvic lymph node dissection in Maoming People’s Hospital from May 2020 to September 2021 were selected as the study subjects.They were divided into control group and observation group according to random number table method,with 30 cases in each group.The control group underwent conventional endotracheal intubation under general anesthesia,and the observation group underwent ultrasound-guided transverse abdominal muscle plane block on the basis of the control group.The postoperative visual analogue score(VAS)score,the total amount of sufentanil in analgesic pump,the number of effective compressions,and the occurrence of adverse reactions were compared between the two groups.Results:At 2,6,12,24 and 48 h after surgery,the VAS scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.022).Within 48 h after surgery,the total amount of sufentanil in analgesic pump and the number of effective compressions in the observation group were lower than those in the control group,and the difference was statistically significant(P=0.032).Conclusion:The application of transverse abdominal muscle plane block in total hysterectomy and pelvic lymph node dissection has significant application effects,it can alleviate postoperative pain,reduce the incidence of adverse reactions,and is beneficial for the patient’s prognosis and recovery.