腹腔镜子宫切除术前与术后行腹横肌平面阻滞对患者术后镇痛及恢复进度的影响

Effects of transversus abdominis plane block before and after laparoscopic hysterectomy on postoperative analgesia and rehabilitation progress of patients

目的:比较腹腔镜子宫切除术前与术后行腹横肌平面(transversus abdominis plane,TAP)阻滞对患者术后镇痛及恢复进度的影响。方法:采用随机数表法将101例腹腔镜子宫切除术患者分为观察组(n=51)与对照组(n=50)。其中观察组患者术前行TAP,对照组患者术后行TAP,比较2组相关参数。结果:2组患者的术中出血量、手术时间及并发症总发生率差异均无统计学意义(均P>0.05)。观察组患者肛门排气时间及总住院时间均短于对照组(均P<0.05)。观察组患者术后2、8、24 h的视觉模拟量表(Visual Analogue Scale,VAS)评分均低于对照组(均P<0.05)。观察组患者术后24 h舒芬太尼用量少于对照组,镇痛补救率低于对照组(均P<0.05)。观察组患者术后24、48 h,40项恢复质量评分量表均高于对照组(均P<0.05)。结论:腹腔镜子宫切除术患者术前行TAP手术时间无变化,且可有效镇痛,减少术后镇痛药物使用量,促进患者术后恢复。

Objective:To compare the effects of transversus abdominis plane(TAP)block before and after laparoscopic hysterectomy on postoperative analgesia and rehabilitation progress of patients.Methods:A total of 101 patients with laparoscopic hysterectomy were divided into an observation group(n=51)and a control group(n=50)by random number table method.The patients in the observation group were treated with TAP before the operation,and the patients in the control group were treated with TAP after the operation,and the related parameters of the 2 groups were compared.Results:There was no significant difference in the intraoperative blood loss,operation time,and total incidence of complications between the 2 groups(all P>0.05).The anal exhaust time and total hospitalization time of the patients in the observation group were shorter than those in the control group(both P<0.05).The Visual Analogue Scale(VAS)score in the observation group was lower than that in the control group at 2,8,and 24 h after the operation(all P<0.05).The dosage of sufentanil in the observation group was less than that in the control group at 24 h after the operation,and the recovery rate of analgesia was lower than that in the control group(both P<0.05).The 40 Recovery Quality Rating Scale in the observation group was higher than that in the control group at 24 and 48 h after the operation(both P<0.05).Conclusion:The preoperative TAP operation time of laparoscopic hysterectomy patients does not change,and it can effectively relieve pain,reduce the use of postoperative analgesic drugs,and promote the postoperative recovery of patients.