超声引导下双侧腹横肌平面阻滞在宫颈癌手术中的应用价值

The Application Value of Ultrasound-guided Bilateral Transverse Abdominis Plane Block in Cervical Cancer Surgery

目的探讨超声引导下双侧腹横肌平面(TAP)阻滞在宫颈癌(UCC)手术中的应用价值。方法选择2021年1月至2023年10月拟在安阳市第六人民医院行手术治疗的70例UCC患者,按随机数字表法分为参考组和复合组,各35例。参考组行全麻,复合组行超声引导下双侧TAP阻滞复合全麻。对比2组血流动力学[平均动脉压(MAP)、心率(HR)]、术后情况[首次肛门排气时间、下床活动时间和疼痛程度]、不良反应。结果T0时组间HR、MAP对比,无统计学差异(P>0.05);T1(切皮时)、T2(术毕时)时2组HR、MAP与T0(麻醉诱导后即刻)时相比均有所降低,但复合组T1、T2时HR、MAP高于参考组(P<0.05)。复合组术后首次下床活动时间、肛门排气时间短于参考组,术后6 h、24 h时疼痛程度、不良反应发生率低于参考组(P<0.05)。结论UCC术中采用超声引导下双侧TAP阻滞复合全麻能够减小血流动力学波动,减轻术后疼痛程度,加速术后康复,安全性较高。

Objective To explore the application value of ultrasound-guided bilateral transverse abdominis plane(TAP)block in cervical cancer(UCC)surgery.Methods 70 UCC patients who were scheduled to receive surgical treatment were selected and randomly divided into a reference group and a composite group,with 35 patients in each group,using a random number table method.The reference group received general anesthesia,while the composite group received ultrasound-guided bilateral TAP block combined with general anesthesia.Compared the hemodynamics[mean arterial pressure(MAP),heart rate(HR)],postoperative conditions[time of first anal exhaust,time of getting out of bed,and degree of pain],and adverse reactions between the 2 groups.Results At T0,there was no statistically significant difference in HR and MAP between the groups(P>0.05);Compared with T0(immediately after anesthesia induction),HR and MAP in both groups decreased at T1(during skin cutting)and T2(after surgery).HR and MAP in the composite group were higher than those in the reference group at T1 and T2(P<0.05);The first postoperative time of getting out of bed and the time for anal exhaust in the composite group were shorter than those in the reference group.The degree of pain and incidence of adverse reactions were lower in the 6 and 24 hours after surgery compared to the reference group(P<0.05).Conclusion Ultrasound guided bilateral TAP block combined with general anesthesia during UCC surgery can reduce hemodynamic fluctuations,alleviate postoperative pain,accelerate postoperative recovery,and have high safety.