氢吗啡酮联合超声引导腹横肌平面阻滞用于妇科腔镜手术早期镇痛  

Clinical Application of Hydromorphone Combined with Ultrasound-Guided Transverses Abdominis Plane Block in Patients Undergoing Gynecologic Laparoscopy

作　　者：董敏[1] 兰艳丽[2] 吴文春[1] 邓孝桢[1] 吕宏伟[1] 

机构地区：[1]襄阳市中医医院/湖北中医药大学附属襄阳医院麻醉科,湖北襄阳441000 [2]襄阳市中心医院/湖北文理学院附属襄阳医院妇产科,湖北襄阳441021

出　　处：《临床医学工程》2016年第5期561-562,共2页Clinical Medicine & Engineering

摘　　要：目的评价氢吗啡酮联合超声引导腹横肌平面(transverses abdominis plane,TAP)阻滞在妇科腔镜手术中的早期镇痛效果。方法纳入42例行妇科腔镜手术的患者,随机分为两组各21例。治疗组患者全麻诱导后在超声引导下行双侧TAP阻滞,手术开始前静脉推注氢吗啡酮10μg/kg;对照组患者推注等量生理盐水。比较两组患者的麻醉效果。结果和对照组相比,治疗组患者术中芬太尼使用剂量明显较少(P<0.05),苏醒期VAS评分、躁动评分明显较低(P<0.01),补救性曲马多的使用剂量明显较少(P<0.01);两组患者的拔管时间以及Ramsay评分无统计学差异(P>0.05)。结论氢吗啡酮联合超声引导下TAP阻滞有助于减轻妇科腔镜患者苏醒期的疼痛不适,提高舒适性,且不影响拔管时间以及镇静程度。Objective To investigate the clinical effect of hydromorphone combined with ultrasound-guided transverses abdominis plane （TAP） block in patients undergoing gynecologic laparoscopy. Methods A total of 42 patients who underwent gynecologic laparoscopy were randomly divided into two groups equally. Ultrasound-guided TAP block was practiced after general anesthesia induction and 10μg/kg hydromorphone was injected before surgery in treatment group; The normal saline was injected in control group. The anesthetic effects of two groups were compared. Results The doses of fentanyl and tramadol of treatment group were significantly fewer than those of control group （P 〈0.05, P 〈0.01）, and VAS pain score and postoperative agitation score were lower than those of control group （P 〈0.01）. No statistical difference was found between two groups in extubation time and Ramsay sedation score （P〉0.05）. Conclusions The application of hydromorphone combined with ultrasound-guided TAP block in patients undergoing gynecologic laparoscopy can reduce pain and discomfort at the recovery period, and improve the comfortable degree, which does not affect extubation time and sedation degree.

关 键 词：氢吗啡酮 腹横肌平面 妇科腔镜 

分 类 号：R614[医药卫生—麻醉学]