腹横肌平面阻滞联合腰-硬联合麻醉对下腹部手术患者术后疼痛及CRP、IL-6水平的影响  

Effect of transversus abdominis plane block combined spinal epidural anesthesia for postoperative analgesia in patients with received lower abdominal surgery and serum CRP and IL-6 Levels

作　　者：方静 FANG Jing(The department of anesthesiology,Wuhan Caidian district people's hospital,Wuhan 430100,China)

机构地区：[1]武汉市蔡甸区人民医院麻醉科,湖北武汉430100

出　　处：《吉林医学》2022年第7期1787-1790,共4页Jilin Medical Journal

摘　　要：目的:分析超声引导下腹横肌平面阻滞联合腰-硬联合麻醉对下腹部手术患者术后疼痛及C-反应蛋白(CRP)、白细胞介素(IL)-6水平的影响。方法:选取收治的下腹部手术患者80例为研究对象,ASA分级为Ⅰ级或Ⅱ级,均行腰-硬联合麻醉,随机分为常规组与研究组各40例,常规组接受经静脉患者自控镇痛(PCIA),研究组接受超声引导下腹横肌平面阻滞(PCIA),比较两组术后不同时间VAS、Ramsay镇静评分、血清CRP和IL-6水平。结果:研究组术后2 h、6 h、24 h时VAS评分均明显低于常规组,差异有统计学意义(P<0.05);术后48 h两组VAS评分差异无统计学意义(P>0.05);两组患者术后不同时间Ramsay镇静评分比较差异无统计学意义(P>0.05);研究组术后6 h、24 h、48 h血清CRP、IL-6水平均明显低于常规组,差异有统计学意义(P<0.05);术后24 h研究组镇痛泵压次数及舒芬太尼用量均明显低于常规组,差异有统计学意义(P<0.05)。结论:腹横肌平面阻滞在患者术后24 h内能够明显改善镇痛效果,降低机体的炎性应激反应。Objective To analyze the effects of ultrasound-guided transversus abdominis plane block combined with combined spinal-epidural anesthesia on postoperative pain,CRP and IL-6 levels in patients undergoing lower abdominal surgery.Method A total of 80 patients with lower abdominal surgery admitted to our hospital were selected.The ASA grade was grade I or gradeⅡ.All underwent combined spinal-epidural anesthesia.They were divided into two groups according to a random number table(n=40):The routine group received patient-controlled analgesia(PCIA)via intravenous patients,and the study group received ultrasound-guided transversus abdominis plane block(PCIA).VAS,Ramsay sedation score,serum CRP and IL-6 were compared between the two groups at different times after surgery Level.Results The VAS scores of the study group at 2,6,and 24 hours after surgery were significantly lower than those of the conventional group(P<0.05);there was no significant difference in VAS scores between the two groups at 48 hours after surgery(P>0.05);the two groups of patients had different time after surgery The Ramsay sedation scores were not significantly different(P>0.05);the serum CRP and IL-6 levels in the study group at 6,24,and 48 hours after surgery were significantly lower than those in the routine group(P<0.05);the analgesic pump pressure in the study group at 24 hours after surgery The frequency and the dosage of sufentanil were significantly lower than those in the conventional group(P<0.05).Conclusion Transversus abdominis plane block can significantly improve the analgesic effect and reduce the body's inflammatory stress response within 24 hours after surgery.

关 键 词：下腹部手术 超声引导下腹横肌平面阻滞 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]