腹腔镜胆囊切除术的单纯全身麻醉和复合腹横肌阻滞的效果分析对比

Comparison of Effects of General Anesthesia and Combined Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy

目的 探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中全身麻醉和复合腹横肌阻滞(transversus abdominis plane block,TAPB)的应用效果。方法 随机选取2020年1月—2021年12月建湖县人民医院收治的80例LC患者为研究对象,行全麻复合TAPB者入观察组(n=40),行静吸复合麻醉者入对照组(n=40),对比两组患者的麻醉效果。结果 观察组术后4 h与术后1 d的视觉模拟评分均低于对照组,差异有统计学意义(P<0.05)。入麻醉后监测治疗室5、10 min内,观察组的Ramsay镇静量表得分分别为(2.40±0.50)分、(2.28±0.45)分,均低于对照组,差异有统计学意义(t=9.015、6.707,P<0.05)。与T0时相比,T1~T3时两组心率、平均动脉压水平波动显著,观察组T1~T3时的心率、平均动脉压水平均低于对照组,差异有统计学意义(P<0.05)。两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论 在LC治疗期间,复合腹横肌阻滞有助于改善患者的Ramsay评分与术后疼痛问题,维持血流动力学稳定,且不会增加头晕、嗜睡等不良反应风险。

Objective To discuss the efficacy of general anesthesia and transversus abdominis plane block(TAPB) applied to laparoscopic cholecystectomy(LC).Methods 80 LC patients admitted to Jianhu County People's Hospital from January 2020 to December 2021 were randomly selected as the study subjects.Patients who received general anesthesia combined with TAPB were included in the observation group(n=40),while those who received intravenous inhalation combined anesthesia were included in the control group(n=40).The anesthesia effects of the two groups of patients were compared.Results The visual simulation scores of the observation group at 4 hours and 1 day after surgery were lower than those of the control group,the difference was statistically significant(P<0.05).Within 5 and 10 minutes of entering PACU,the Ramsay sedation scale scores of the observation group were(2.40±0.50) points and(2.28±0.45) points,respectively,lower than those of the control group,the difference was statistically significant(t=9.015,6.707,P<0.05).Compared with T0,there were significant fluctuations in heart rate and average arterial pressure levels between the two groups at T1~T3.The heart rate and average arterial pressure levels in the observation group at T1~T3 were lower on average than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion During LC treatment,combined transversal block helps to improve Ramsay score and postoperative pain,maintain hemodynamic stability,and does not increase the risk of adverse reactions such as dizziness and drowsiness.