腹股沟疝手术患儿伤口局部浸润与超声引导下腹横肌平面阻滞的早期镇痛效果比较  

Comparison of early analgesic effect of local infiltration anesthesia and ultrasound guided planar block anesthesia in children with inguinal hernia after operation

作　　者：王成 戚洪亮[1] 夏尚伏 WANG Cheng;QI Hong-liang;XIA Shang-fu(Department of Anesthesiology, Peopled Liberation Army No. 105 Hospital, Hej~i Anhui 230031, China.)

机构地区：[1]安徽省合肥市中国人民解放军第一零五医院麻醉科,安徽合肥230031

出　　处：《临床和实验医学杂志》2018年第10期1113-1116,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的比较小儿腹股沟疝手术后应用伤口局部浸润麻醉与超声引导下腹横肌平面阻滞麻醉的早期镇痛效果。方法回顾性纳入2015年10月至2017年5月于医院实施腹腔镜腹股沟斜疝疝囊内环口高位缝扎术治疗的患儿127例,根据麻醉镇痛方法不同分为两组,对照组63例采用伤口局部浸润麻醉,实验组64例采用超声引导下腹横肌平面阻滞麻醉。比较两组患儿的术前、术后(术后苏醒时、术后1 h、术后6 h、术后12 h)镇痛效果,以及术前、术后生理参数指标[呼吸(RR)、心率(HR)、平均动脉压(MAP)、氧分压(SpO_2)],不良反应等。结果实验组术前、术后苏醒时、术后1 h、术后6 h及术后12 h各时间点CHEOPS评分与FLACC评分均明显低于对照组,组间比较差异具有显著性(P<0.05)。实验组术后苏醒时HR、MAP指标低于对照组(P<0.05),术后6 h RR、HR、MAP、SpO_2指标与对照组相比差异也均具有显著性(P<0.05)。对照组与实验组术后恶心呕吐发生率分别为11.11%、6.25%,组间比较无统计学差异(P>0.05)。结论对于腹股沟疝手术患儿采用超声引导下腹横肌平面阻滞麻醉,患儿生理参数指标波动小,早期镇痛效果更为理想,且不会引起严重不良反应,临床应用价值极高。Objective To compare the early analgesic effects of local infiltration anesthesia and ultrasound guided planar block anesthesia in children with inguinal hernia after operation. Methods From October 2015 to May 2017,127 cases of children with laparoscopic inguinal hernia hernia high ligation treatment were selected in this study,according to different methods of anesthesia and analgesia they were divided into two groups,the control group of 63 patients with wound local anesthesia,64 cases in the experimental group by ultrasound guided transversus abdominis plane block anesthesia. The analgesic effects before and after surgery（ after resuscitation,1 h after operation,6 h after operation,and 12 h after operation）,and the preoperative and postoperative physiological parameters breath（ RR） Heart rate（ HR）,mean arterial pressure（ MAP）,partial oxygen pressure（ Sp O2）,adverse reactions,etc,were compared between the two groups. Results The CHEOPS score and FLACC score in the experimental group were significantly lower than those in the control group at the time of recovery,1 h,6 h and 12 h at different time points after operation,and there was a significant difference between the two groups（ P〈0. 05）. The indexes of HR and MAP in the experimental group were lower than those in the control group（ P〈0. 05）,and there were significant differences in 6 h RR,HR,MAP and Sp O2 between the experimental group and the control group（ P〈0. 05）. The incidence of nausea and vomiting in the control group and the experimental group was11. 11 % and 6. 25 %,respectively,and there was no statistical difference between the groups（ P〈0. 05）. Conclusion When ultrasound guided transversus abdominis plane block anesthesia is performed in patients with inguinal hernia surgery,the fluctuations of physiological parameters are small,the early analgesic effect is more ideal,and will not cause serious adverse reactions. It has high clinical promotion value.

关 键 词：小儿 腹股沟疝手术 腹横肌平面阻滞 局部浸润麻醉 镇痛效果 

分 类 号：R726.1[医药卫生—儿科]