超声引导下腹横肌平面阻滞复合全身麻醉对子宫肌瘤手术患者的影响

Influence of Ultrasound-guided Transversus Abdominis Plane Block Combined with General Anesthesia on Patients Undergoing Hysteromyoma Surgery

目的:探讨超声引导下腹横肌平面阻滞(TAPB)复合全身麻醉对子宫肌瘤手术患者的影响。方法:回顾性选取2021年2月—2023年2月务川仡佬族苗族自治县人民医院收治的93例子宫肌瘤手术患者。根据麻醉方式的不同将其分为联合组(n=46)和单一组(n=47)。单一组给予全身麻醉,联合组给予TAPB复合全身麻醉。比较两组时间指标,术后2 h、8 h、24 h、48 h疼痛程度及镇静效果、舒适度,麻醉满意度,不良反应及并发症。结果:联合组术后苏醒时间、自主呼吸恢复时间均早于单一组,住院时间短于单一组,镇痛泵按压次数少于单一组,差异有统计学意义(P<0.05)。联合组术后2 h、8 h、24 h、48 h视觉模拟评分法(visual analogue scale,VAS)评分低于单一组,差异有统计学意义(P<0.05)。术后2 h、8 h、24 h、48 h联合组舒适度评分高于单一组,差异有统计学意义(P<0.05)。联合组麻醉满意度评分为(21.42±2.53)分,明显高于单一组的(18.14±2.31)分,差异有统计学意义(P<0.05)。联合组苏醒期躁动发生率明显低于单一组,差异有统计学意义(P<0.05);两组患者进行3个月随访,均未出现阴道出血、宫腔感染、体温异常等并发症。结论:TAPB复合全身麻醉对子宫肌瘤手术患者镇痛效果显著,且安全性良好。

Objective:To investigate the influence of ultrasound-guided transversus abdominis plane block(TAPB)combined with general anesthesia on patients undergoing hysteromyoma surgery.Method:A total of 93 patients with uterine fibroid surgery admitted to the People's Hospital of Wuchuan Gelao and Mao Nationalities Autonomous County from February 2021 to February 2023 were retrospectively selected.They were divided into combined group(n=46)and single group(n=47)according to different anesthesia methods.The single group was given general anesthesia,and the combined group was given TAPB combined general anesthesia.The time indexes,pain degree,sedation effect,comfort level at 2 h,8 h,24 h and 48 h after surgery,anesthesia satisfaction,adverse reactions and complications of the two groups were compared.Result:The postoperative recovery time and spontaneous breathing recovery time of the combined group were earlier than those of the single group,the hospitalization time was shorter than that of the single group,and the number of analgesic pump presses was less than that of the single group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the combined group were lower than those of the single group at 2 h,8 h,24 h,and 48 h after surgery,the differences were statistically significant(P<0.05).The comfort scores of the combined group were higher than those of the single group at 2 h,8 h,24 h,and 48 h after surgery,the differences were statistically significant(P<0.05).The satisfaction score of anesthesia in the combined group was(21.42±2.53)points,which was significantly higher than(18.14±2.31)points in the single group,and the differences were statistically significant(P<0.05).The incidence of agitation during the awakening period in the combined group was significantly lower than that in the single group,and the difference was statistically significant(P<0.05);all patients underwent a 3-month follow-up,and the results showed that neither group experienced complications such as vaginal bleeding,uterine infection,or abnormal body temperature.Conclusion:TAPB combined with general anesthesia has significant analgesic effect and good safety in patients undergoing hysteromyoma surgery.