椎板后路阻滞对腹腔镜肾切除术患者术后镇痛的影响  

Effect of retrolaminar block on postoperative analgesia in patients undergoing laparoscopic nephrectomy

作　　者：徐新鹏 刘德行[1] 朱宇航[1] 李娟[1] 陈慧[1] XU Xinpeng;LIU Dexing;ZHU Yuhang;LI Juan;CHEN Hui(Department of Anesthesiology,the Affiliated Hospital of Zunyi Medical College,Zunyi 563000,China)

机构地区：[1]遵义医学院附属医院麻醉科

出　　处：《临床麻醉学杂志》2019年第10期965-968,共4页Journal of Clinical Anesthesiology

摘　　要：目的观察椎板后路阻滞(retrolaminar block,RLB)对腹腔镜肾切除术患者术后镇痛效果及术后早期恢复的影响。方法腹腔镜肾切除术患者60例,男31例,女29例,年龄18~65岁,ASAⅠ或Ⅱ级,采用随机数字表法分为两组,每组30例:RLB组(R组)与局部浸润组(L组)。R组于全麻诱导后在超声引导下于术侧行RLB,L组于手术结束时行局部浸润麻醉,两组局麻药皆采用0.4%罗哌卡因30 ml。两组术中均行静-吸复合麻醉,术后行舒芬太尼PCIA。记录术后拔管时间、PACU停留时间、镇痛泵有效按压次数和首次下床活动时间。结果L组拔管时间、PACU停留时间明显长于R组(P<0.05),术后24、48 h L组镇痛泵有效按压次数明显多于R组(P<0.05),首次下床活动时间明显长于R组(P<0.05)。结论与局部浸润比较,椎板后路阻滞可为腹腔镜肾切除术患者提供有效术后镇痛,并有利于术后恢复。Objective To observe the effect of retrolaminar block(RLB)on postoperative analgesia and early postoperative recovery of laparoscopic nephrectomy.Methods Sixty patients with laparoscopic nephrectomy underwent laparoscopic nephrectomy,31 males and 29 females,aged 18-65 years,falling into ASA physical statusⅠorⅡ,were randomly divided into RLB group(group R)and local infiltration group(group L),n=30 in each group.RLB was performed on the operative side under ultrasound guidance after general anesthesia induction in group R.Group L underwent local infiltration and analgesia at the end of the operation.Both groups received 0.4%ropivacaine 30 ml.All patients underwent combined intravenous-inhalation anesthesia and sufentanil patient-controlled intravenous analgesia(PCIA)after operation.The extubation time and PACU stay time,the number of effective compressions of PCIA,and initial activity time after operation were recorded.Results The extubation time and PACU stay time in group L were longer than those in group R(P<0.05).The number of effective compressions in group L was significantly higher than that in group R at 24 and 48 h after operation(P<0.05),and initial activity time in group L was significantly longer than that in group R(P<0.05).Conclusion The retrolaminar block can provide an effective analgesic effect during perioperative period of laparoscopic nephrectomy and is beneficial for postoperative recovery.

关 键 词：椎板后路阻滞 腹腔镜肾切除术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学] R699.2[医药卫生—外科学]