腹横肌平面阻滞联合气管插管全身麻醉在小儿腹腔镜阑尾切除术中的应用效果

Application Effect of Transversus Abdominis Plane Block Combined with Tracheal Intubation General Anesthesia in Pediatric Laparoscopic Appendectomy

目的:探讨腹横肌平面阻滞联合气管插管全身麻醉在小儿腹腔镜阑尾切除术中的应用效果。方法:选取2022年9月—2023年8月于东莞市妇幼保健院行腹腔镜阑尾切除术治疗的患儿58例为研究对象,按照随机数字表法分为对照组与试验组,各29例。试验组采用腹横肌平面阻滞联合气管插管全身麻醉,对照组仅采用气管插管全身麻醉。比较两组临床效果。结果:试验组丙泊酚用量、舒芬太尼用量少于对照组,苏醒时间、拔除气管导管时间、术后运动恢复时间短于对照组,试验组术后2、6、12、24、48 h视觉模拟评分及不良反应总发生率低于对照组,差异有统计学意义(P<0.05);试验组手术开始时(T₂)、手术结束时(T₃)、拔除气管导管时(T₄)的心率均低于对照组,气管导管插入后、T₂、T₃、T₄的血氧饱和度均高于对照组,差异有统计学意义(P<0.05)。结论:腹横肌平面阻滞联合气管插管全身麻醉能够减少腹腔镜阑尾切除术患儿麻醉药物使用剂量和不良反应,且术后疼痛程度更低,麻醉苏醒时间更短,生命体征更稳定。

Objective:To investigate the application effect of transversus abdominis plane block combined with tracheal intubation general anesthesia in pediatric laparoscopic appendectomy.Methods:A total of fifty-eight children who underwent laparoscopic appendectomy in Dongguan Maternal and Child Health Hospital from September 2022 to August 2023 were selected as the study objects,and were divided into control group and experimental group according to random number table method,with twenty-nine cases in each group.The experimental group received transversus abdominis plane block combined with tracheal intubation general anesthesia,and the control group only received tracheal intubation general anesthesia.The clinical effect of the two groups was compared.Results:The dosage of propofol and sufentanil in experimental group were lower than those in control group,and the recovery time,tracheal catheter removal time and postoperative exercise recovery time in experimental group were shorter than those in control group,visual analogue scale score and the total incidence of adverse reactions at 2,6,12,24 and 48 h after operation in experimental group were lower than those in control group,and the differences were statistically significant(P<0.05);at the beginning of surgery(T_(2)),at the end of surgery(T_(3)),and at the time of tracheal catheter withdrawal(T_(4)),heart rate of the experimental group was lower than that of the control group,after insertion of the tracheal catheter,T_(2),T_(3),and T_(4),the blood oxygen saturation of the experimental group was higherthan that of the control group,and the differences were statistically significant(P<0.05).Conclusion:The application of transversus abdominis plane block combined with tracheal intubation general anesthesia in children with laparoscopic appendectomy can reduce the dosage of anesthetic drugs and adverse reactions,and the degree of postoperative pain is lower,the anesthesia recovery time is shorter,and the vital signs are more stable.