BACKGROUND Postoperative complications are important factors affecting the survival time and quality of life of patients undergoing radical gastrectomy.AIM To investigate and compare the anesthetic effects of intraven...BACKGROUND Postoperative complications are important factors affecting the survival time and quality of life of patients undergoing radical gastrectomy.AIM To investigate and compare the anesthetic effects of intravenous general anesthesia combined with epidural anesthesia or ultrasound-guided bilateral transversus abdominal plane block(TAPB)in gastric cancer patients undergoing laparoscopic radical gastrectomy.METHODS The clinical data of 85 patients who underwent laparoscopic radical gastrectomy in our hospital from December 2020 to January 2023 were retrospectively collected and divided into a TAPB group(n=45)and epidural anesthesia group(n=40)according to the different anesthesia and analgesia programs used.The TAPB group received general anesthesia combined with TAPB,and the epidural anesthesia group received general anesthesia combined with epidural anesthesia.The pain status,cognitive status,intestinal barrier indicators,recovery quality,and incidence of complications were compared between the two groups.RESULTS Compared with the epidural anesthesia group,the TAPB group’s visual analog scale scores were significantly lower 6 h,12 h,24 h and 48 h after surgery(P<0.05).The incidence of postoperative cognitive dysfunction(POCD)in the TAPB group was significantly lower than that in the epidural anesthesia group,and the Mini-mental State Examination score 24 h after surgery was significantly higher in the TAPB group than the epidural anesthesia group(P<0.05).The levels of diamine oxidase and plasma D-lactate were significantly lower in the TAPB group than the epidural anesthesia group 24 h after surgery(P<0.05).The agitation score and the incidence of agitation during recovery were significantly lower in the TAPB group than epidural anesthesia group(P<0.05).The total incidence of postoperative complications in the TAPB group was 4.44%,significantly lower than the 20.00%in the epidural anesthesia group(P<0.05).CONCLUSION Compared with epidural anesthesia combined with general anesthesia,TAPB combined with general anesthesia had a good analgesic effect in laparoscopic radical gastrectomy and can further reduce the incidence of POCD and postoperative complications,improve the levels of intestinal barrier indicators,and improve postoperative recovery quality.展开更多
目的:观察三种不同入路的腹横肌平面阻滞(TAP)应用于小儿下腹部手术术后镇痛的效果。方法:选择90例下腹部手术的患儿,年龄1~6岁,按照随机数字表法将其分为L、C、H三组,每组30例。L组行全身麻醉+肋缘下TAP,C组行全身麻醉+侧路TAP,H组行...目的:观察三种不同入路的腹横肌平面阻滞(TAP)应用于小儿下腹部手术术后镇痛的效果。方法:选择90例下腹部手术的患儿,年龄1~6岁,按照随机数字表法将其分为L、C、H三组,每组30例。L组行全身麻醉+肋缘下TAP,C组行全身麻醉+侧路TAP,H组行全身麻醉+后路TAP。观察并记录术后2、6、12、24 h的CHEOPS疼痛评分、Ramesay评分,以及与术后镇痛相关的不良反应。结果:与术后2 h比较,L组的术后12、24 h及C、H组的术后24 h CHEOPS评分均升高(P<0.05)、Ramesay评分下降(P<0.05);与L组术后12 h比较,C、H组术后12 h CHEOPS评分升高(P<0.05)、Ramesay评分下降(P<0.05)。与H组比较,L组、C组的下肢运动异常的发生率更低(P<0.05)。结论:三种腹横肌平面阻滞均可以有效地缓解小儿下腹部手术术后12 h内的疼痛,肋缘下入路TAP镇痛时间稍短,后路入路TAP有一定的下肢肌力下降。展开更多
目的比较腹横肌平面（TAP）阻滞与骶管麻醉在儿童下腹部手术镇痛的应用价值。方法计算机检索Cochrane-Library、Pubmed、 Embase、 Medline、 Web of Science、 CNKI、万方、维普图书馆数据库，收集TAP和骶管麻醉应用于儿童下腹部手术...目的比较腹横肌平面（TAP）阻滞与骶管麻醉在儿童下腹部手术镇痛的应用价值。方法计算机检索Cochrane-Library、Pubmed、 Embase、 Medline、 Web of Science、 CNKI、万方、维普图书馆数据库，收集TAP和骶管麻醉应用于儿童下腹部手术的随机对照试验（RCT）。主要结局指标为术后面部表情评分法（FLACC）评估疼痛，术后呕吐发生率。用Revman5．3软件进行统计分析。结果系统检索后纳入4篇文献．共235例患儿，其中TAP组患）L118倒，骶管麻醉患儿117例。Meta分析结果显示，在术后6h、12h、18h、24h，TAP阻滞和骶管麻醉在儿童下腹部手术后镇痛评分无明显差异[6h（P〈0．0001），12h（P=0．26），18h（P=0．27），24h（P=0．13）]。患儿术后恶心呕吐发生率两者比较差异均无统计学意义[OR0．67，（95％CIO．13-3.39）]。结论TAP阻滞与骶管麻醉对儿童下腹部手术后镇痛效果相似，并且不影响术后恶心呕吐发生率，是一种安全、有效的镇痛方法。展开更多
文摘BACKGROUND Postoperative complications are important factors affecting the survival time and quality of life of patients undergoing radical gastrectomy.AIM To investigate and compare the anesthetic effects of intravenous general anesthesia combined with epidural anesthesia or ultrasound-guided bilateral transversus abdominal plane block(TAPB)in gastric cancer patients undergoing laparoscopic radical gastrectomy.METHODS The clinical data of 85 patients who underwent laparoscopic radical gastrectomy in our hospital from December 2020 to January 2023 were retrospectively collected and divided into a TAPB group(n=45)and epidural anesthesia group(n=40)according to the different anesthesia and analgesia programs used.The TAPB group received general anesthesia combined with TAPB,and the epidural anesthesia group received general anesthesia combined with epidural anesthesia.The pain status,cognitive status,intestinal barrier indicators,recovery quality,and incidence of complications were compared between the two groups.RESULTS Compared with the epidural anesthesia group,the TAPB group’s visual analog scale scores were significantly lower 6 h,12 h,24 h and 48 h after surgery(P<0.05).The incidence of postoperative cognitive dysfunction(POCD)in the TAPB group was significantly lower than that in the epidural anesthesia group,and the Mini-mental State Examination score 24 h after surgery was significantly higher in the TAPB group than the epidural anesthesia group(P<0.05).The levels of diamine oxidase and plasma D-lactate were significantly lower in the TAPB group than the epidural anesthesia group 24 h after surgery(P<0.05).The agitation score and the incidence of agitation during recovery were significantly lower in the TAPB group than epidural anesthesia group(P<0.05).The total incidence of postoperative complications in the TAPB group was 4.44%,significantly lower than the 20.00%in the epidural anesthesia group(P<0.05).CONCLUSION Compared with epidural anesthesia combined with general anesthesia,TAPB combined with general anesthesia had a good analgesic effect in laparoscopic radical gastrectomy and can further reduce the incidence of POCD and postoperative complications,improve the levels of intestinal barrier indicators,and improve postoperative recovery quality.
文摘目的:观察三种不同入路的腹横肌平面阻滞(TAP)应用于小儿下腹部手术术后镇痛的效果。方法:选择90例下腹部手术的患儿,年龄1~6岁,按照随机数字表法将其分为L、C、H三组,每组30例。L组行全身麻醉+肋缘下TAP,C组行全身麻醉+侧路TAP,H组行全身麻醉+后路TAP。观察并记录术后2、6、12、24 h的CHEOPS疼痛评分、Ramesay评分,以及与术后镇痛相关的不良反应。结果:与术后2 h比较,L组的术后12、24 h及C、H组的术后24 h CHEOPS评分均升高(P<0.05)、Ramesay评分下降(P<0.05);与L组术后12 h比较,C、H组术后12 h CHEOPS评分升高(P<0.05)、Ramesay评分下降(P<0.05)。与H组比较,L组、C组的下肢运动异常的发生率更低(P<0.05)。结论:三种腹横肌平面阻滞均可以有效地缓解小儿下腹部手术术后12 h内的疼痛,肋缘下入路TAP镇痛时间稍短,后路入路TAP有一定的下肢肌力下降。
文摘目的比较腹横肌平面（TAP）阻滞与骶管麻醉在儿童下腹部手术镇痛的应用价值。方法计算机检索Cochrane-Library、Pubmed、 Embase、 Medline、 Web of Science、 CNKI、万方、维普图书馆数据库，收集TAP和骶管麻醉应用于儿童下腹部手术的随机对照试验（RCT）。主要结局指标为术后面部表情评分法（FLACC）评估疼痛，术后呕吐发生率。用Revman5．3软件进行统计分析。结果系统检索后纳入4篇文献．共235例患儿，其中TAP组患）L118倒，骶管麻醉患儿117例。Meta分析结果显示，在术后6h、12h、18h、24h，TAP阻滞和骶管麻醉在儿童下腹部手术后镇痛评分无明显差异[6h（P〈0．0001），12h（P=0．26），18h（P=0．27），24h（P=0．13）]。患儿术后恶心呕吐发生率两者比较差异均无统计学意义[OR0．67，（95％CIO．13-3.39）]。结论TAP阻滞与骶管麻醉对儿童下腹部手术后镇痛效果相似，并且不影响术后恶心呕吐发生率，是一种安全、有效的镇痛方法。
