超声引导腹横肌平面阻滞对结肠癌开腹手术患者循环应激及术后镇痛的影响  

Effect of Ultrasound-guided transversus abdominis plane block on cyclic stress and postoperative analgesia in patients after abdominal surgery

作　　者：董盛龙[1] 朱少飞[1] 林赛娟[1] 王卡[1] 

机构地区：[1]海口市人民医院麻醉科,570208

出　　处：《实用医学杂志》2017年第2期259-262,共4页The Journal of Practical Medicine

摘　　要：目的:探讨全麻诱导后超声引导双侧腹横肌平面阻滞对结肠癌开腹手术患者循环应激及术后镇痛的影响。方法 :将60例患者随机均分为两组,于全麻诱导后接受超声引导腹横肌平面阻滞,其中观察组30例注射罗哌卡因,对照组30例注射生理盐水,术中应用丙泊酚联合瑞芬太尼,术后给予舒芬太尼自控镇痛。对比两组麻醉及手术效果。结果:观察组术后苏醒时间更短(P<0.05);观察组切皮2 min、术毕时收缩压、舒张压及心率低于对照组(P<0.05);观察组术中丙泊酚及瑞芬太尼用量少于对照组(P<0.05);观察组术后1、4、8、12 h VAS疼痛评分低于对照组(P<0.05);观察组术后24 h内舒芬太尼自控镇痛用量低于对照组(P<0.05),镇痛泵按压次数少于对照组(P<0.05),术后舒适度高于对照组(P<0.05)。结论 :全麻诱导后超声引导双侧腹横肌平面阻滞有助于降低术中维持麻醉药物剂量,提升患者术后舒适度。Objective To investigate the effect of ultrasound-guided transversus abdominis plane blockafter general anesthesia induction on cyclic stress and postoperative analgesia in patients treated with abdominalsurgery. Methods Sixty patients scheduled for elective abdominal surgery were divided into 2 groups with 30 casesin each. All were treated with ultrasound-guided transversus abdominis plane block after general anesthesia induction,and 30 cases in observation group received ropivacaine,while those in control group saline. Anesthesia maintainedby propofol combined with remifentanil during surgery,and postoperative analgesia by sufentanil. The effect ofanesthesia and operation were compared. Results Compared with control group,observation group needed lesstime for analepsia（P 〈0.05）,and there were lower blood pressure and heart rate at 2 min after skin incision andimmediately after surgery（P〈 0.05）. Less propofol and remifentanil were needed in surgery and less sufentanilafter surgery in observation group（P 〈0.05）. The VAS pain score was lower 1 h,4 h,8 h and 12 h after surgery（P 0.05）,and there were less times for pressing analgesic pump（P 〈0.05）. Patients in observation group hadhigher comfort degree after surgery（P 0.05）. Conclusion Ultrasound-guided transversus abdominis plane blockafter general anesthesia induction is helpful to reduce intraoperative anesthesia used for anesthesia maintenance,and can improve patients′ comfort after surgery.

关 键 词：超声引导 腹横肌平面阻滞 神经阻滞 手术 镇痛 

分 类 号：R614[医药卫生—麻醉学] R735.35[医药卫生—外科学]