腹腔镜辅助腹横肌平面阻滞在腹股沟疝修补术后镇痛中的应用

Application of laparoscopic-assisted transversus abdominis plane block in post-operative analgesia after inguinal hernia repair

目的观察腹腔镜辅助腹横肌平面阻滞用于腹股沟疝术后镇痛的效果。方法选取2022年1—8月济南市中心医院胃肠外科腹股沟疝患者90例,采用随机数字法随机将患者分成对照组和试验组,各45例。2组均行腹腔镜经腹腹膜前修补术。试验组术中加行患侧腹横肌平面罗哌卡因阻滞。记录术后4、6、12、24、48、72 h的疼痛视觉模拟评分(VAS)和腹横肌平面阻滞相关不良反应发生情况。结果试验组在术后4、6、12 h的VAS评分均较对照组显著降低[2(1,2)vs 3(2,3)、2(2,2)vs 3(3,4)、3(2,3)vs 4(3,4),P均<0.05];2组术后24、48、72 h的VAS评分比较,差异无统计学意义(P>0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论腹腔镜辅助腹横肌平面阻滞用于腹股沟疝术后镇痛效果好,且安全性高。

Objective To observe the effect of laparoscopic-assisted transversus abdominis plane block for postoperative analgesia after inguinal hernia repair.Methods A total of 90 patients with inguinal hernia in the Department of Gastrointestinal Surgery,Affiliated Jinan Central Hospital from January 2022 to August 2022 were selected and randomly divided into control(n=45)and experimental groups(n=45)according to random number method.Both groups underwent laparoscopic trans-abdominal preperitoneal repair.In the experimental group,ropivacaine block at the plane of the ipsilateral transverse abdominis was additionally performed.The visual analogue scale(VAS)score and the occurrence of adverse reactions related to transverse abdominis plane block were recorded at 4,6,12,24,48,and 72 h after operation.Results The VAS scores of the experimental group were significantly lower than those of control group at 4,6,and 12 h[2(1,2)vs 3(2,3);2(2,2)vs 3(3,4);3(2,3)vs 4(3,4)](P<0.05).There was no significant difference in the VAS scores between the two groups at 24,48,and 72 h(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The laparoscopic-assisted transversus abdominis plane block is effective and safe for postoperative analgesia after inguinal hernia repair.