腹横筋膜平面阻滞联合盐酸羟考酮超前镇痛在腹腔镜子宫肌瘤核除术中的应用  

Application of Preemptive Analgesia of Transversus Abdominis Plane Blocking Combined with Oxycodone Hydrochloride in Myomectomy Under Laparoscope

作　　者：郝晓燕[1] 韩利平[1] 高守琳 

机构地区：[1]辽宁省大连市友谊医院,辽宁大连116001

出　　处：《航空航天医学杂志》2016年第8期958-961,共4页Journal of Aerospace medicine

摘　　要：目的研究腹横筋膜平面阻滞联合盐酸羟考酮超前镇痛在腹腔镜子宫肌瘤核除术中的应用。方法选择腹腔镜下子宫肌瘤核除术患者60例,随机分为两组,T组和D组。T组在麻醉后切皮前于超声引导下行TAP阻滞和手术结束前给予盐酸羟考酮0.1 mg/kg静脉推注;D组于手术结束前给予芬太尼1μg/kg静脉推注。分别记录术后2 h、4 h、8 h、12 h、24 h患者的VAS评分和Ramsay评分,及两组患者不良反应的发生率和术后镇痛满意度。结果 T组患者的VAS评分明显低于D组,而Ramsay评分则无统计学差别,T组不良事件的发生率低于D组,镇痛满意率高于D组。结论腹横筋膜平面阻滞联合盐酸羟考酮超前镇痛用于腹腔镜子宫肌瘤核除术能够减少患者术后疼痛,增加术后镇痛满意度,且不良反应发生率低。Objective To study the application of preemptive analgesia of TAP blocking combined with oxycodone hydrochloride in myomectomy under laparoscope. Methods Our hospital selected 60 cases of patients to undergo myomectomy under laparoscope and randomly divided them into two groups： T and D groups. T group was treated with TAP blocking under ultrasonic guidance after anesthesia and before skin incision and intravenous injection of 0. 1 mg/kg oxycodone hydrochloride before ending of the surgery. D group was treated with intravenous injection of 1μg/kg remifentanil before ending of the surgery. The patients’ VAS and Ramsay scores as well as the occurrence rate of adverse reaction and the satisfaction of postoperative analgesia of two group patients were recorded at 2 hours,4 hours,8 hours,12 hours and24 hours after the surgery,respectively. Results VAS of T group was significantly lower than that of D group,while Ramsay score had no statistical difference. The occurrence rate of adverse event of T group was lower than that of D group and the satisfaction rate of analgesia was higher than D group. Conclusions Preemptive analgesia of TAP blocking combined with oxycodone hydrochloride in myomectomy under laparoscope can mitigate the patients’ postoperative pain and increase the satisfaction of postoperative analgesia. Besides,it has lower occurrence rate of adverse reaction after operations.

关 键 词：腹横筋膜平面阻滞 盐酸羟考酮 超前镇痛 腹腔镜子宫肌瘤核除术 

分 类 号：R737.33[医药卫生—肿瘤]