超声引导双侧腹直肌鞘阻滞对胃癌根治术后镇痛的影响  

Effect of ultrasound-guided bilateral rectus abdominis sheath block on postoperative analgesia after radical gastrectomy

作　　者：白建云[1] 刘玉红 李丹 惠勇[1] 刘宏飞[1] BAI Jianyun;LIU Yuhong;LI Dan;HUI Yong;LIU Hongfei(Anesthesiology Department,Yulin No.2 Hospital,Yulin 719000,China)

机构地区：[1]榆林市第二医院麻醉科,陕西榆林719000

出　　处：《临床医学研究与实践》2020年第29期64-66,共3页Clinical Research and Practice

摘　　要：目的探讨超声引导双侧腹直肌鞘阻滞对胃癌根治术后镇痛的影响。方法选取2019年8月至2020年1月于我院行胃癌根治术治疗的80例患者作为研究对象,根据入院顺序将其随机分为对照组与研究组,各40例。对照组未进行腹直肌鞘阻滞,研究组给予超声引导下双侧腹直肌鞘阻滞。比较两组患者术后不同时间点的静息、运动VAS评分、Ramsay镇静评分、术后24 h的舒芬太尼用量、镇痛泵按压次数及术后不良反应发生情况。结果术后6、12、24、48 h,两组的静息和运动VAS评分均高于术后1 h,差异具有统计学意义(P<0.05);术后6、12、24、48 h,研究组的静息VAS评分均低于对照组,差异具有统计学意义(P<0.05);术后6、12 h,研究组的运动VAS评分均低于对照组,差异具有统计学意义(P<0.05);两组各时间点的Ramsay镇静评分比较,差异无统计学意义(P>0.05)。术后24 h,研究组的舒芬太尼用量、镇痛泵按压次数均少于对照组,差异具有统计学意义(P<0.05)。两组的术后不良反应总发生率比较,差异无统计学意义(P>0.05)。结论超声引导双侧腹直肌鞘阻滞可有效缓解胃癌根治术后疼痛,且安全性高,值得临床推广应用。Objective To investigate the effect of ultrasound-guided bilateral rectus abdominis sheath block on postoperative analgesia after radical gastrectomy.Methods Eighty patients who underwent radical gastrectomy in our hospital from August 2019 to January 2020 were selected as the research objects and randomly divided into control group and study group according to the order of admission,with 40 cases in each group.The control group was not given rectus abdominis sheath block,while the study group was given ultrasound-guided bilateral rectus abdominis sheath block.The resting and exercise VAS score,Ramsay sedation score at different time points after operation,sufentanil dosage,times of pressing analgesia pump at 24 h after operation and occurrence of postoperative adverse reactions were compared between the two groups.Results At 6,12,24 and 48 h after operation,the resting and exercise VAS scores of the two groups were higher than those at 1 h after operation,and the differences were statistically significant(P<0.05);At 6,12,24 and 48 hours after operation,the resting VAS score of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05);At 6 and 12 h after operation,the exercise VAS score of the study group were lower than those of the control group(P<0.05);there were no significant differences in Ramsay sedation score at each time point between the two groups(P>0.05).At 24 h after operation,the sufentanil dosage and times of pressing analgesia pump in the study group were less than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Ultrasound-guided bilateral rectus abdominis sheath block can effectively relieve postoperative pain after radical gastrectomy,and has high safety,which is worthy of clinical promotion and application.

关 键 词：超声引导 双侧腹直肌鞘阻滞 胃癌根治术 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]