超声引导下腹横肌平面阻滞麻醉对急性阑尾炎腹腔镜手术患者的影响

Effect of Ultrasound-guided Transversus Abdominis Plane Block Anesthesia on Patients with Acute Appendicitis Undergoing Laparoscopic Surgery

目的:探究超声引导下腹横肌平面阻滞(transversus abdominis plane block,TAPB)麻醉对急性阑尾炎(acute appendicitis,AA)腹腔镜手术患者的影响。方法:选取2022年6月—2023年9月于徐州市第六人民医院行腹腔镜阑尾切除术的96例AA患者为研究对象,采用随机数表法分为观察组和对照组,各48例。对照组患者行全身麻醉,观察组行超声引导下TAPB麻醉联合全身麻醉。观察并比较两组患者各时间点心率、平均动脉压水平、全身麻醉药物使用量、术后复苏质量及胃肠功能恢复情况。结果:观察组T1~T5各时间点的心率及平均动脉压明显低于对照组,差异有统计学意义(P<0.05)。观察组舒芬太尼用量、丙泊酚用量明显较对照组更少,差异有统计学意义(P<0.05)。观察组呼之睁眼时间、拔除气管导管时间、完全苏醒时间及苏醒后数字评估量表(numerical ratings scale,NRS)评分均明显低于对照组,觉醒/镇静观察评分(observer's assessment of alertness/sedation,OAA/S)评分明显高于对照组,差异有统计学意义(P<0.05)。观察组术后首次排气时间及肠鸣音恢复时间明显较对照组更短,胃肠道症状评定量表(gastrointestinal symptoms rating scale,GSRS)评分明显较对照组更低,差异有统计学意义(P<0.05)。结论:超声引导下TAPB麻醉在AA腹腔镜手术中的效果显著,能有效稳定患者术中生理指标,减少麻醉药物用量,促进术后快速恢复,降低疼痛程度,同时加速了胃肠道功能恢复。

Objective:To explore the effect of ultrasound-guided transversus abdominis plane block(TAPB)anesthesia on patients with acute appendicitis(AA)undergoing laparoscopic surgery.Method:A total of 96 AA patients who underwent laparoscopic appendectomy in the Sixth People's Hospital of Xuzhou from June 2022 to May 2023 were selected and randomly divided into the observation group and the control group,48 cases in each group.The control group received general anesthesia,while the observation group received ultrasound-guided TAPB anesthesia combined with general anesthesia.The heart rate,average arterial pressure,amount of general anesthesia drugs,postoperative resuscitation quality and gastrointestinal function recovery of patients in the two groups were observed and compared at various time points.Result:The heart rate and mean arterial pressure at T1 to T5 in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The consumption of Sufentanil and Propofol in the observation group were significantly less than those in the control group,and the differences were statistically significant(P<0.05).The eye opening time,tracheal catheter removal time,full recovery time and numerical ratings scale(NRS)score after recovery in the observation group were significantly lower than those in the control group,and the observer's assessment of alertness/sedation(OAA/S)score was significantly higher than that in the control group,and the differences were statistically significant(P<0.05).The first postoperative exhaust time and bowel sound recovery time in the observation group were significantly earlier than those in the control group,and the gastrointestinal symptoms rating scale(GSRS)score was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:Ultrasound-guided TAPB anesthesia has a remarkable effect in laparoscopic surgery for AA,which can effectively stabilize patients'intraoperative physiological indexes,reduce the amount of anesthetic drugs,promote rapid postoperative recovery,reduce the degree of pain,and accelerate the recovery of gastrointestinal function.