腹横筋膜阻滞联合帕瑞昔布钠对日间腹腔镜胆囊切除术后镇痛效果的观察  

Comparison of Ultrasound-guided Transversus Abdominis Plane Block and Parecoxib Sodium for Postoperative Analgesia in Laparoscopic Cholecystectomy

作　　者：殷文渊[1] 王苑[1] 沈莉丽 周姝婧[1] 闻大翔[1] 

机构地区：[1]上海交通大学医学院附属仁济医院麻醉科,上海浦东新区200127 [2]上海市闵行区中心医院麻醉科,上海闵行区200127

出　　处：《河北医学》2016年第6期886-889,共4页Hebei Medicine

基　　金：上海自然科学课题基金项目;(编号:11ZR1423200)

摘　　要：目的:旨在研究超声引导下的腹横筋膜阻滞联合帕瑞昔布钠对腹腔镜胆囊切除术后疼痛的影响。方法:70例患者按照随机数字表法分为两组:PS组(单纯适用帕瑞昔布钠组)和PS+TAP组(腹横筋膜阻滞联合帕瑞昔布组)。记录出PACU、术后6h以及术后24h的视觉模拟(VAS)评分、术后恶心呕吐(PONV)评分和曲马多的需求量。结果:和PS组相比,PS+TAP组在术后6h VAS评分降低,差异具有统计学意义(P<0.05),在出PACU和术后24h这两组没有统计学差异;并且PS+TAP组患者在术后6h和术后24的PONV评分低于PS组,差异具有统计学意义(P<0.05)。结论:超声引导下的腹横筋膜阻滞联合帕瑞昔布钠多模式镇痛可以减轻腹腔镜胆囊切除术的术后疼痛。Objective： To evaluate the effect of multi-module analgesia of transversus abdominis plane block combined with parecoxib sodium and its efficacy with only parecoxib sodium usage in decreasing postoperative pain in patients undergoing laparoscopic cholecystectomy（ LC） during general anesthesia.Method： 70 patients were randomly and blindly divided into two groups： PS group（ parecoxib sodium only） and PS＋TAP group（ transversus abdominis plane block combined with parecoxib sodium）. The visual analog scale（ VAS）and postoperative nausea and vomiting（ PONV） were recorded in the post-anesthesia care unit（ PACU）,6hours after the LC,24 hours after LC. By the way,the usage of tramadol was recorded at the time points as well.Results： Compared with PS group,PS＋TAP decreased the VAS score significantly 6 hours after LC（ P〈0.05）. There were no differences of VAS scores in the PACU and 24 hours after LC between PS and PS＋TAP groups. Moreover,PS＋TAP group reduced the PONV scores compared with PS group in 6 hours after LC and24 hours after LC（ P〈0.05）.Conclusion： Transversus abdominis plane block combined with parecoxib sodium provide significant effect on reducing VAS and PONV scores,and improve patients outcome after ambulatory LC.

关 键 词：腹横筋膜阻滞 帕瑞昔布钠 腹腔镜胆囊切除术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]