静吸复合麻醉联合超声引导腹横筋膜平面阻滞在子宫切除术中的应用效果

Application Effect of Intravenous-inhalation Combined Anesthesia Combined with Ultrasound-guided Transversus Abdominis Plane Block in Hysterectomy

目的:探讨静吸复合麻醉联合超声引导腹横筋膜平面阻滞在子宫切除术中的应用效果。方法:选取2021年7月-2022年12月南通市第三人民医院收治的88例子宫切除术患者,根据随机数表法分为观察组与对照组,各44例。对照组采用静吸复合麻醉,观察组在对照组基础上采用超声引导腹横筋膜平面阻滞麻醉。比较两组自主呼吸恢复时间、苏醒时间、拔管时间、术后不良反应发生情况及术后1 h、6 h、12 h、24 h视觉模拟评分法(VAS)评分。结果:与对照组相比,观察组自主呼吸恢复时间、苏醒时间及拔管时间较早,差异有统计学意义(P<0.05)。两组术后疼痛VAS评分组间、时间、交互比较,差异有统计学意义(P<0.05);与术后1 h相比,两组术后6 h、12 h的VAS评分均升高,差异有统计学意义(P<0.05);观察组术后24 h的VAS评分与术后1 h对比,差异无统计学意义(P>0.05);对照组术后24 h的VAS评分高于术后1 h,差异有统计学意义(P<0.05);与术后6 h相比,两组术后12 h、24 h的VAS评分均降低,差异有统计学意义(P<0.05);与术后12 h相比,两组术后24 h的VAS评分均降低,差异有统计学意义(P<0.05);观察组术后6 h、12 h、24 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为4.55%,低于对照组的18.18%,差异有统计学意义(P<0.05)。结论:静吸复合麻醉联合超声引导腹横筋膜平面阻滞在子宫切除术患者中可缩短自主呼吸恢复时间、苏醒时间及拔管时间,镇痛作用显著,还可减少不良反应。

Objective:To investigate the application effect of intravenous-inhalation combined anesthesia combined with ultrasound-guided transversus abdominis plane block in hysterectomy.Method:A total of 88 patients with hysterectomy who admitted to the Third People's Hospital of Nantong from July 2021 to December 2022 were randomly divided into observation group and control group,with 44 cases in each group.The control group was given intravenous-inhalation combined anesthesia,and the observation group was given ultrasound-guided transversus abdominis plane block on the basis of the control group.The spontaneous breathing recovery time,recovery time,extubation time,postoperative adverse reactions and visual analogue scale(VAS)scores at 1 h,6 h,12 h and 24 h after surgery were compared between two groups.Result:Compared with the control group,the spontaneous breathing recovery time,recovery time and extubation time in the observation group were earlier,and the differences were statistically significant(P<0.05).There were significant differences in postoperative pain VAS score between two groups,time and interaction(P<0.05);compared with 1 h after surgery,the VAS scores at 6 h and 12 h after surgery in two groups were increased,the differences were statistically significant(P<0.05);there was no significant difference in VAS scores between the observation group at 24 h and 1 h after surgery(P>0.05);the VAS score at 24 h after surgery in the control group was higher than that at 1 h after surgery,and the difference was statistically significant(P<0.05);compared with 6 h after surgery,the VAS scores of two groups at 12 h and 24 h after surgery were decreased,the differences were statistically significant(P<0.05);compared with 12 h after surgery,the VAS scores of two groups at 24 h after surgery were decreased,the differences were statistically significant(P<0.05);the VAS scores at 6 h,12 h and 24 h after surgery of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 4.55%,which was lower than 18.18%in the control group,and the difference was statistically significant(P<0.05).Conclusion:intravenous-inhalation combined anesthesia combined with ultrasound-guided transversus abdominis plane block in hysterectomy can shorten the recovery time of spontaneous breathing,recovery time and extubation time,the analgesic effect is significant,and can also reduce adverse reactions.