超声引导腹横肌平面阻滞联合氢吗啡酮超前镇痛在腹腔镜胆囊切除术的镇痛效果观察  

Preemptive Analgesic of Ultrasound-guided Transverses Abdominis Plane Block Combined with Hydromorphone in Patients Undergoing Laparoscopic Cholesystectomy

作　　者：董敏[1] 吴文春[1] 曹雅军[1] 邓孝桢[1] 吕宏伟[1] 

机构地区：[1]湖北中医药大学附属襄阳市中医医院麻醉科,湖北襄阳441000

出　　处：《湖北民族学院学报（医学版）》2016年第1期32-34,共3页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的研究超声引导腹横肌平面阻滞(TAPB)联合氢吗啡酮超前镇痛在腹腔镜胆囊切除术(LC)的镇痛效果。方法择期行LC的38例患者随机分为联合组和对照组,每组各19例,两组全麻诱导后超声引导下行双侧TAPB,手术开始前联合组静脉推注氢吗啡酮10μg/kg,对照组注射等量生理盐水,记录两组患者拔管后1h时Price-henry疼痛评分、躁动分级以及Ramsay镇静评分,观察补救性镇痛药的需要例数以及术后静脉自控镇痛(PICA)的按压次数。结果联合组患者Price-henry疼痛评分、躁动评分明显降低,PICA按压次数明显低于对照组(P<0.05);联合组补救性镇痛药的使用率明显低于对照组(P<0.05);两组患者Ramsay镇静评分差异无统计学意义(P>0.05)。结论 TAPB联合氢吗啡酮超前镇痛有助于减轻LC患者围术期疼痛,不影响镇静深度,安全性高、不良反应较少,具有较好的临床应用价值。Objective To assess the clinical effect of ultrasound-guided transverses abdominis plane block（TAPB） combined with hydromorphone in patients undergoing laparoscopic cholesystectomy（LC）.Methods Totally 38 patients who underwent LC were assinged into control group and combine group randomly （n= 19）.Ultrasound-guided TAPB was practiced after general anesthesia induction and 10 μg/kg hydromorphone was injected before surgery in combine group;The normal saline was injected in control group.The Price-henry pain score,postoperative agitation score and Ramsay score were recored lh after extubation ;The number of postoperative rescue analgesic and compressin number of PICA were recorded as well. Results The Price-henry pain score, postoperative agitation score and compressin number of PCIA in combine group were less than those of control group（P〈0.05）;Compared with control group,the number of postoperative rescue analgesic in combine group was decreased obviously （P 〈 0. 05） ;But there was no significant difference in the Ramsay score between the two groups（P 〉0.05） .Conclusion The preemptive analgesic of ultrasound-guided TAPB combined with hydromorphone can meet the needs of patients, enhance the comfort after surgry and improve pa- tient＇s satisfaction.

关 键 词：超声引导 氢吗啡酮 腹横肌平面阻滞 腹腔镜胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]