超声引导下行双侧腹横肌平面-腹直肌鞘阻滞麻醉辅助全麻对腹腔镜胰十二指肠切除术患者的影响  

Effects of ultrasound guided bilateral transverse abdominis plane-rectus sheath block anesthesia assisted general anesthesia in patients with laparoscopic pancreaticoduodenectomy

作　　者：李梦倩[1] 吴树彪[1] 李彬[1] Li Meng-qian;Wu Shu-biao;Li Bin(Department of Anesthesiology and Perioperative Medicine,The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院麻醉与围术期医学部,河南郑州450000

出　　处：《四川生理科学杂志》2022年第4期612-614,715,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨超声引导下行双侧腹横肌平面(Ultrasound-guided plane of bilateral transverse abdominal muscles,TAPB)-腹直肌鞘阻滞(Rectus sheath block,RSB)辅助全麻对腹腔镜胰十二指肠切除术患者肺功能指标的影响。方法:随机将我院2019年5月至2021年5月期间收治的99例择期行十二指肠切除术患者分为两组,对照组49例采用全身麻醉方式,观察组50例行超声引导下双侧TAPB-RSB麻醉辅助全麻方式,观察两组患者手术一般情况、肺功能、术后恢复情况。结果:术后,观察组瑞芬太尼、舒芬太尼使用量、静脉自控镇痛泵按压次数少于对照组,补救镇痛率低于对照组(P<0.05);观察组一秒用力呼气容积、最大呼气峰值流速、一秒用力呼气容积/用力肺活量以及最大呼气率均高于对照组(P<0.05);观察组首次下床、排气时间,在麻醉复苏室停留以及住院时间均短于对照组(P<0.05);观察组恶心呕吐、躁动、嗜睡、低氧血症发生率均低于对照组(P<0.05)。结论:相比较于单一使用全身麻醉,对腹腔镜胰十二指肠切除术患者予以超声引导下双侧TAPB-RSB麻醉辅助全麻方式进行麻醉,可更高的改善手术一般情况,促进术后恢复,且对肺功能的影响更小。Objective:To investigate the effect of ultrasound-guided Ultrasound-guided plane of bilateral transverse abdominal muscles(TAPB)-Rectus sheath block(RSB)assisted general anesthesia on laparoscopic pancreatoduodenum effects of pulmonary function indicators in patients undergoing enterectomy.Methods:A total of 99 patients with elective duodenectomy who were admitted to our hospital from May 2019 to May 2021 were randomly divided into two groups,49 patients in the control group received general anesthesia,and 50 patients in the observation group received ultrasound guidance under the bilateral TAPB-RSB anesthesia assisted by general anesthesia,the general operation,pulmonary function and postoperative recovery of the two groups were observed.Results:After operation,the dosage of remifentanil and sufentanil,the number of times of intravenous patient-controlled analgesia pump pressing in the observation group were less than those in the control group,and the rescue analgesia rate was lower than that in the control group(P<0.05).The expiratory volume,peak expiratory flow rate,forced expiratory volume in one second/forced vital capacity and maximum expiratory rate were all higher than those in the control group(P<0.05).The hospital stay was shorter than that in the control group(P<0.05);the incidences of nausea,vomiting,restlessness,lethargy and hypoxemia in the observation group were lower than those in the control group(P<0.05).Conclusion:Compared with single use of general anesthesia,anesthesia in patients undergoing laparoscopic pancreaticoduodenectomy with bilateral TAPB-RSB anesthesia assisted by general anesthesia can better improve the general condition of the operation and promote postoperative anesthesia.recovery with less impact on lung function.

关 键 词：胰十二指肠切除术 双侧腹横肌平面阻滞麻醉 腹直肌鞘阻滞麻醉 肺功能 

分 类 号：R61[医药卫生—外科学]