超声引导下双侧腹横肌平面阻滞对腹腔镜结肠癌手术的镇痛效果评价  

Evaluation of Analgesic Effect of Ultrasonic-guided Bilateral Transversal Muscle Block in Laparoscopic Colon Cancer Surgery

作　　者：师瑾 贺兴义[1] 宣慧仁[1] SHI Jin;HE Xingyi;XUAN Huiren(Department of Anesthesiology,Third People's Hospital of Datong City,Datong,Shanxi Province,037000 China)

机构地区：[1]大同市第三人民医院麻醉科,山西大同037000

出　　处：《系统医学》2021年第17期38-40,共3页Systems Medicine

摘　　要：目的探讨超声引导下双侧腹横肌平面阻滞(TAPB)对腹腔镜结肠癌手术的镇痛效果。方法选取2018年12月—2020年6月该院收治的92例结肠癌患者作为研究对象,采用交替分组法将其分为对照组和观察组,各46例。对照组采用静吸复合全身麻醉,观察组采用超声引导下双侧TAPB。对比两组术后1、4、12 h静息时、咳嗽时视觉模拟评分法(VAS)评分,以及麻醉前、术后24 h游离皮质醇水平。结果观察组术后1、4、12 h静息时VAS评分为(1.25±0.74)分、(1.94±0.93)分、(3.08±1.05)分,咳嗽时VAS评分(2.18±0.72)分、(3.11±1.03)分、(3.62±1.11)分,均低于对照组静息时(2.58±0.87)分、(2.94±0.95)分、(3.48±1.14)分,咳嗽时(3.17±0.69)分、(4.28±0.91)分、(4.95±1.06)分,两组时点、时点与组间交互对比,差异有统计学意义(P<0.05)。观察组术后24 h游离皮质醇水平(442.26±85.47)nmol/L低于对照组(624.18±93.34)nmol/L,差异有统计学意义(t=9.749,P<0.001)。结论超声引导下双侧TAPB在腹腔镜结肠癌手术中可有效减轻术后疼痛,缓解机体应激反应。Objective To investigate the analgesic effect of ultrasound-guided bilateral transverse abdominal muscle plane block(TAPB)on laparoscopic colon cancer surgery.Methods A total of 92 colon cancer patients admitted to the hospital from December 2018 to June 2020 were selected as the research objects,and they were divided into a control group and an observation group by alternate grouping method,with 46 cases in each group.The control group was given intravenous inhalation combined with general anesthesia,and the observation group was given bilateral TAPB under ultrasound guidance.The VAS scores at rest and cough at 1 h,4 h,12 h after operation,and the levels of free cortisol before anesthesia and 24 h after operation were compared between the two groups.Results The VAS scores in the observation group at rest 1 h,4 h,and 12 h after operation were(1.25±0.74)points,(1.94±0.93)points,(3.08±1.05)points,and the VAS score during cough was(2.18±0.72)points,(3.11±1.03)points,(3.62±1.11)points,which were lower than those of the control group at rest(2.58±0.87)points,(2.94±0.95)points,(3.48±1.14)points,and cough(3.17±0.69)points,(4.28±0.91)points,(4.95±1.06)points,there was a statistically significant difference between the two groups in time point,time point and the group,the difference was statistically significant(P<0.05).The 24 h free cortisol level(442.26±85.47)nmol/L of the observation group was lower than that of the control group(624.18±93.34)nmol/L,the difference was statistically significant(t=9.749,P<0.001).Conclusion Bilateral TAPB under ultrasound guidance can effectively reduce postoperative pain and relieve the body's stress response during laparoscopic colon cancer surgery.

关 键 词：腹腔镜结肠癌手术 超声引导 双侧腹横肌平面阻滞 镇痛 应激反应 

分 类 号：R4[医药卫生—临床医学]