超声引导下腹横肌平面阻滞联合丙泊酚静脉泵注在腹膜透析置管术中的应用效果观察

Observation on application effect of ultrasound-guided transversus abdominis plane block combined with intravenous infusion of propofol in peritoneal dialysis catheterization

目的 观察超声引导下腹横肌平面阻滞联合丙泊酚静脉泵注在腹膜透析置管术中的应用效果。方法 选取符合腹膜透析指征的终末期肾脏病(ESRD)患者68例作为研究对象,使用随机数字表法分成对照组和实验组,每组34例。对照组腹膜透析置管术中采用传统局部浸润麻醉,实验组腹膜透析置管术中采用超声引导下腹横肌平面阻滞联合丙泊酚静脉泵注麻醉。比较两组患者术后不同时间视觉模拟评分法(VAS)评分、血流动力学指标[平均动脉压(MAP)、心率(HR)]及不良反应发生率。结果 术后0.5 h,两组VAS评分对比没有差异(P>0.05);术后1、6 h,实验组VAS评分分别为(2.89±0.74)、(1.02±0.30)分,均低于对照组的(3.82±0.87)、(3.20±0.41)分(P<0.05)。麻醉前,两组MAP、HR对比没有差异(P>0.05);术后30 min,实验组MAP(85.41±8.31)mm Hg(1 mm Hg=0.133 kPa)、HR(71.43±6.53)次/min低于对照组的(97.84±9.25)mm Hg、(92.54±6.85)次/min(P<0.05)。两组不良反应发生率对比没有差异(P>0.05)。结论 在腹膜透析置管术中应用超声引导下腹横肌平面阻滞联合丙泊酚静脉泵注可明显减轻患者的痛苦,改善患者血流动力学指标,且安全性较高,在临床中可以运用推广。

Objective To observe the application effect of ultrasound-guided transversus abdominis plane block combined with intravenous infusion of propofol in peritoneal dialysis catheterization.Methods 68 patients with end-stage renal disease who met the indications for peritoneal dialysis were selected as the research subjects.All patients were divided into a control group and an experimental group using random numerical table,with 34 cases in each group.The control group received traditional local anesthesia in peritoneal dialysis catheterization,while the experimental group received ultrasound-guided transversus abdominis plane block combined with intravenous infusion of propofol in peritoneal dialysis catheterization.The visual analogue scale(VAS)score and hemodynamic indicators[mean arterial pressure(MAP),heart rate(HR)]at different postoperative time periods,and incidence of adverse reactions were compared between two groups.Results At 0.5 h postoperatively,there was no difference in the comparison of VAS scores between the two groups(P>0.05).At 1 and 6 h postoperatively,the VAS scores of the experimental group were(2.89±0.74)and(1.02±0.30)points,which were lower than(3.82±0.87)and(3.20±0.41)points of the control group(P<0.05).Before anesthesia,there was no difference in the comparison of MAP and HR between the two groups(P>0.05).At 30 min postoperatively,the experimental group had MAP of(85.41±8.31)mm Hg(1 mm Hg=0.133 kPa)and HR of(71.43±6.53)beats/min,which were lower than(97.84±9.25)mm Hg and(92.54±6.85)beats/min of the control group(P<0.05).There was no difference in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ultrasound-guided transversus abdominis plane block combined with intravenous infusion of propofol in peritoneal dialysis catheterization can effectively alleviate pain,improve hemodynamic indicators,and has high safety.It can be applied and promoted in clinical practice.