超声引导下腹横肌平面阻滞联合全身麻醉用于腹腔镜子宫切除术的效果

Effect of ultrasound-guided transversus abdominis plane block combined with general anesthesia in laparoscopic hysterectomy

目的研究超声引导下腹横肌平面阻滞(TAPB)联合全身麻醉应用于腹腔镜子宫切除术中的价值。方法抽取2019年1月至2021年12月洛阳市妇幼保健院收治的行腹腔镜子宫切除术的患者196例,按照随机数字表法分为对照组和研究组,每组98例。对照组采用全身麻醉,研究组采用超声引导下TAPB联合全身麻醉。比较两组术后恢复情况、视觉模拟评分法(VAS)评分、简易智能精神状态检查量表(MMSE)评分、白细胞介素-6(IL-6)水平及不良反应发生率。结果研究组肛门首次排气时间、拔除导管时间、住院时间短于对照组(P<0.05);术后2、12、24、48 h,研究组VAS评分均低于对照组(P均<0.05);术后即刻、术后24 h及术后48 h,研究组IL-6水平低于对照组(P<0.05);术后12、48 h,研究组MMSE评分高于对照组(P<0.05);研究组不良反应发生率(3.06%,3/98)低于对照组(12.24%,12/98),P<0.05。结论超声引导下TAPB联合全身麻醉应用于腹腔镜子宫切除术中能明显缩短患者术后恢复时间,改善机体炎症,缓解疼痛症状,促进患者认知功能恢复,且无明显不良反应。

ObjectiveTo study the effect of ultrasound-guided transversus abdominis plane block(TAPB)combined with general anesthesia in laparoscopic hysterectomy.MethodsA total of 196 patients who underwent laparoscopic hysterectomy in Luoyang Maternal and Child Health Hospital from January 2019 to December 2021 were selected,and they were divided into control group and study group according to random number table method,with 98 cases in each group.The control group received general anesthesia,and the study group received ultrasound-guided TAPB combined with general anesthesia.The postoperative recovery,visual analogue scale(VAS)score,mini-mental state examination(MMSE)score,level of interleukin-6(IL-6)and the incidence of adverse reactions were compared between the two groups.ResultsCompared with the control group,the first anal exhaust time,catheter removal time and hospital stay of the study group were shorter(P<0.05).Compared with the control group,VAS scores of the study group were lower at 2,12,24 and 48 hours after surgery(all P<0.05).Compared with the control group,the level of IL-6 in the study group were lower immediately after surgery,24 hours after surgery and 48 hours after surgery(P<0.05).Compared with the control group,MMSE scores of the study group were higher 12 hours and 48 hours after surgery(P<0.05).The incidence of adverse reactions in the study group was 3.06%(3/98),lower than the 12.24%(12/98)in the control group(P<0.05).ConclusionsThe application of ultrasound-guided TAPB combined with general anesthesia in laparoscopic hysterectomy can significantly shorten the postoperative recovery time of patients,improve the body inflammation,relieve pain symptoms,and promote the recovery of patients’cognitive function,without obvious adverse reactions.