超声引导下腹横肌平面阻滞复合静脉靶控输注瑞芬太尼用于腹透管置入术的研究  

Application of the ultrasound-guided transversus abdominis plane block combined with remifentanil target-controlled infusion in placement of peritoneal dialysis catheter

作　　者：陆军 席鹏 陈辉 熊源长 Lu Jun;Xi Peng;Chen Hui;Xiong Yuanchang(Faculty of Anesthesiology,Changhai Hospital,Naval Military Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学附属长海医院麻醉学部

出　　处：《海军医学杂志》2019年第5期440-443,共4页Journal of Navy Medicine

摘　　要：目的评估超声引导下腹横肌平面阻滞复合静脉靶控输注瑞芬太尼应用于腹膜透析管置入术的效果。方法本试验采用数字表法随机对照方法,选择拟行"腹膜透析管置入术"患者40例,随机分为超声引导下腹横肌平面阻滞(TAP)复合静脉靶控输注瑞芬太尼组(T组)和局部麻醉组(L组)。记录2组各时间点的NRS评分、心率(HR)、平均动脉压(MAP)和血氧饱和度(SpO 2);记录2组患者的局麻药使用量及手术时间,并记录不良反应。结果T2-T5时间点NRS评分T组低于L组(P<0.05),心率及平均动脉压T组较L组稳定(P<0.05),手术时间及局麻药的使用量T组较L组少(P<0.05)。结论超声引导下腹横肌平面阻滞联合使用静脉靶控输注瑞芬太尼可为腹透管置入术患者提供良好的镇痛镇静效果,同时可以缩短手术时间、降低不良事件发生率。Objective To evaluate the efficacy of ultrasound-guided TAP block combined with remifentanil target-controlled infusion(TCI)in peritoneal dialysis catheterization. Methods This is a randomized controlled clinical trial.A total of 40 patients undergoing catherization for peritoneal dialysis were randomized into 2 groups:the ultrasound-guided TAP block combined with remifentanil TCI group(or group T)and the local anesthesia group(or group L).NRS scores,heart rate(HR),mean arterial pressure(MAP)and SpO 2 of the 2 groups were recorded at different time points,and the dosages of local anesthesia and surgical time,as well as adverse reactions were recorded for both groups. Results NRS scores in group T were significantly lower than those in Group L(P<0.05).HR and MAP in group T were more stable,as compared with those of Group L(P<0.05),and surgical time and dosages of local anesthesia in group T were less as compared with those in group L(P<0.05).Conclusion The combination of TAP and remifentanil TCI could render effective analgesia and sedation,and had the advantages of shorter surgical time and lower rate adverse reactions.

关 键 词：腹横筋膜平面阻滞 静脉靶控输注 瑞芬太尼 局麻 腹透管置管术 

分 类 号：R69[医药卫生—泌尿科学]