腹横肌平面阻滞和切口浸润麻醉在腹腔镜直肠癌根治术后镇痛效果的比较  

Comparison of the Analgesia Effects of Laparoscopic Radical Resection of Rectal Cancer between Transversus Abdominis Plane Block and Local Incision Infiltration Anesthesia

作　　者：蔡少彦[1] 张蕾[1] 郑良杰[1] CAI Shaoyan,ZHANG Lei,ZHENG Liangjie(Shantou Central Hospital,Shantou 515031,Chin)

机构地区：[1]汕头市中心医院,广东汕头515031

出　　处：《中外医学研究》2018年第12期1-3,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较超声引导下的腹横肌平面阻滞(transversus abdominis plane block,TAPB)和切口局部浸润麻醉用于腹腔镜直肠癌根治术术后镇痛的效果。方法:选取腹腔镜直肠癌根治术患者60例,随机分为两组,最终纳入51例,分别为TAP阻滞组(A组):25例,术前行双侧超声引导下的腹横肌平面阻滞;切口浸润麻醉组(B组):26例,手术结束时在腹部切口局部行浸润麻醉。观察两组患者术后即刻(0 h)及1、2、6、12、24 h静息时的VAS评分,并分别记录额外需要的镇痛药和相关的不良反应。结果:A组患者在术后1、2、6、12 h的VAS均明显低于B组,差异均有统计学意义(P<0.05);A组氟比洛芬酯用量显著少于B组,差异有统计学意义(P<0.05);两组舒芬太尼及不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:超声引导下的腹横肌平面阻滞用于腹腔镜直肠癌根治术术后镇痛,与局部药浸润麻醉相比效果更确切,且不良反应发生率没有明显增加。Objective：To compare the effect of two different analgesic patterns of ultrasound guided transversus abdominis plane block（TAPB） and local incision infiltration anesthesia on the patients undergoing laparoscopic radical resection of rectal cancer.Method：A total of 60 patients with laparoscopic radical resection of rectal cancer were randomly divided into two groups,the final inclusion of 51 cases.And they were divided into two groups,the TAP block group（group A） had 25 cases,ultrasound guided transversus abdominis plane block was performed bilaterally before surgery;the incision anesthesia group（group B） had 26 cases,local infiltration anesthesia was performed in the trocar incision area at the end of the operation.The VAS scores of the two groups were observed at the time the operation ended as well（0 hour） and at 1,2,6,12,24 hours when resting,and the additional required analgesics and associated adverse reactions were recorded respectively.Result：The visual analogue scale scores of group A was significantly lower than those of group B at 1,2,6,12 hours after surgery,the differences were statistically significant（P0.05）;the dosage of Flurbiprofen Axetil in group A was significantly less than that in group B,the differences was statistically significant（P0.05）;while there was no significant difference in the dosage of Sufentanil between the two groups（P0.05）.Also there was no statistically significant difference in the incidence of adverse events between the two groups（P0.05）.Conclusion：Compared with local drug infiltration anesthesia,the analgesic effect of ultrasound-guided transverse plane block used in patients of laparoscopic radical resection of rectal cancer after surgery is better,and the dosage of other intravenous analgesic drugs can be significantly reduced,while the incidence of adverse reactions do not increase.

关 键 词：腹腔镜直肠癌根治术 局麻药 镇痛 

分 类 号：R614[医药卫生—麻醉学] R735.37[医药卫生—外科学]