超声引导腹横肌平面阻滞对腹腔镜下宫颈癌术中和术后镇痛效果的影响  

作　　者：袁俊波[1] 姜慧芳[1] 连燕虹[1] 方军[1] 

机构地区：[1]浙江省肿瘤医院麻醉科,310022

出　　处：《浙江临床医学》2017年第2期341-342,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨超声引导腹横肌平面（TAP）阻滞对腹腔镜下宫颈癌术中和术后镇痛效果的影响。方法择期行腹腔镜下宫颈癌手术的患者50例，随机分为S组（TAP阻滞＋PCIA）和C组（单纯PCIA）。麻醉诱导后S组行超声引导双侧TAP阻滞，各注入0．375％罗哌卡因20ml，C组不实施TAP阻滞。两组术后均行PCIA。记录两组患者麻醉诱导前及清醒拔管时的血压变化。记录术中舒芬太尼的用量及术后24h镇痛泵的按压次数。记录术后2、4、6、12、24h的疼痛评分。结果S组患者诱导前和拔管时的平均动脉压无明显波动；S组术中舒芬太尼用量和术后24h镇痛泵的按压次数均较C组明显减少（P〈0．05）；S组术后2、4、6、12h的VAS评分显著低于C组（P〈0．05）。结论超声引导TAP阻滞减少了腹腔镜下宫颈癌手术患者术中阿片类镇痛药的用量，增强了术后镇痛效果。Objective To observe the effects of ultrasound-guided transverse abdominis plane （ TAP ） block on intraoperative and postoperative analgesic efficacy in patients undergoing laparoscopic radical surgery of cervical cancer. Methods Fifty patients scheduled for laparoscopic radical surgery of cervical cancer under general anesthesia were randomly divided into 2 groups （ n=25each ） ： group S （ TAP＋PCIA ） and group C （ PCI ） . After induction of anesthesia, ultrasound-guided bilateral TAP block was performed and 0.375% ropivacaine was injected in group S, while nothing was done ingroup C. The hemodynamic parameters during induction of anesthesia and extubation were recorded. The consumption of sufentanil during operation and compressin numbers of PCIA were recored. And VAS score at 2, 4, 6, 12 and 24 h after operation were recorded. Results The haemodynamic parameters in group S maintain even stable during induction of anesthesia and extubation; Compared with group C, the consumption of sufentanil during operation and compressin numbers of PCIA were less in group S; VAS at 2, 4, 6 and 12h after operation were significantly lower （ P〈0.05 ） in group S. Conclusion Ultrasound-guided TAP block reduce the postoperative sufentanil consumption and enhances the eddicacy of postoperative analgesia in patients undergoing laparoscopic radical surgery of cervical cancer.

关 键 词：超声引导 腹横肌平面阻滞 腹腔镜手术 宫颈癌 镇痛 

分 类 号：R971.2[医药卫生—药品]