腹横肌平面阻滞和局部浸润麻醉对腹部手术患者麻醉效果和安全性的影响

Effect of Transversus Abdominis Plane Block and Local Infiltration Anesthesia on Anesthesia Effect and Safety in Patients Undergoing Abdominal Surgery

目的:探讨腹横肌平面阻滞和局部浸润麻醉对腹部手术患者麻醉效果和安全性的影响。方法:选择2019年6月—2022年3月在佳木斯骨科医院接受腹腔镜下结肠癌根治术治疗的结肠癌患者100例作为研究对象,根据简单数字表法分为研究组与对照组,各50例。对照组给予局部浸润麻醉,研究组给予腹横肌平面阻滞,比较两组康复情况、不良反应发生率、镇痛效果及中性粒细胞凋亡情况。结果:研究组术后住院时间、术后首次下床时间、术后首次通气时间、术后流质饮食时间短于对照组(P<0.05);研究组等不良反应发生率低于对照组(P<0.05);研究组术后6、12、24与48 h疼痛VAS评分低于对照组(P<0.05);研究组术后1、2、3 d中性粒细胞凋亡指数高于对照组(P<0.05)。结论:相对于局部浸润麻醉,腹横肌平面阻滞能促进腹部手术患者康复,降低不良反应发生率,促进中性粒细胞凋亡,具有更好的镇痛效果。

Objective:To investigate the effects of transversus abdominis plane block and local infiltration anesthesia on the anesthetic effect and safety of patients undergoing abdominal surgery.Methods:A total of 100 patients with colon cancer who underwent laparoscopic radical resection of colon cancer in Jiamusi Orthopedic Hospital from June 2019 to March 2022 were selected as the research objects.According to the simple number table method,they were divided into study group and control group,with 50 cases in each group.The control group was given local infiltration anesthesia,and the study group was given transversus abdominis plane block.The rehabilitation,incidence of adverse reactions,analgesic effect and neutrophil apoptosis were compared between the two groups.Results:The postoperative hospitalization time,the first time of getting out of bed after operation,the first time of ventilation after operation and the time of liquid diet after operation in the study group were shorter than those in the control group(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).The pain VAS scores at 6,12,24 and 48 h after operation in the study group were lower than those in the control group(P<0.05).The neutrophil apoptosis index of the study group was higher than that of the control group at 1,2 and 3 days after operation(P<0.05).Conclusion:Compared with local infiltration anesthesia,transversus abtris plane block can promote the recovery of patients undergoing abdominal surgery,reduce the incidence of adverse reactions,promote neutrophil apoptosis,and has a better analgesic effect.