开腹直肠癌根治术行超声引导下连续腹横肌平面阻滞的镇痛效果分析  

Analysis of the Analgesic Effect of Continuous Transversus Abdominis Plane Block under Ultrasound Guidance in Open Radical Resection for Rectal Cancer

作　　者：周香莲 林宏福 李华 杨鹍华 ZHOU Xianglian;LIN Hongfu;LI Hua;YANG Kunhua(Department of Anesthesiology,Nanshan District Shekou People's Hospital,Shenzhen,Guangdong Province,518067 China;Department of General Surgery,Nanshan District Shekou People's Hospital,Shenzhen,Guangdong Province,518067 China)

机构地区：[1]深圳市南山区蛇口人民医院麻醉科,广东深圳518067 [2]深圳市南山区蛇口人民医院普通外科,广东深圳518067

出　　处：《世界复合医学》2022年第5期78-80,92,共4页World Journal of Complex Medicine

摘　　要：目的分析开腹直肠癌根治术患者于超声引导下行连续腹横肌平面(TAP)阻滞的镇痛效果。方法选择2018年1月—2019年10月深圳市南山区蛇口人民医院收治的开腹直肠癌根治术患者78例,根据数表法随机分成对照组(予以自控静脉镇痛)和观察组(予以连续TAP阻滞镇痛),各39例。统计并比较两组术中麻醉药用量和液体出入量、疼痛数字评分量表(NRS)评分结果,术后下床、首次排气及住院时间与补救镇痛情况,并记录下两组不良反应发生率。结果观察组术中瑞芬太尼用量(1465.85±480.26)μg少于对照组,差异有统计学意义(t=2.662,P<0.05)。观察组术后2、4、8、12、24 h疼痛评分均低于对照组,术后首次排气及下床时间短于对照组,差异有统计学意义(P<0.05)。结论予以开腹直肠癌根治术患者超声引导下连续TAP阻滞镇痛效果显著,能促进其术后早期恢复,减少不良反应出现,安全性较高。Objective To analyze the analgesic effect of ultrasound-guided continuous transversus abdominis plane block(TAP)in patients undergoing open radical resection for rectal cancer.Methods A total of 78 patients with open radical resection of rectal cancer who were treated in Nanshan District Shekou People's Hospital of Shenzhen City from January 2018 to October 2019 were selected.According to the digital table method,the patients were randomly divided into the control group(with patient-controlled intravenous analgesia)and the observation group(with continuous TAP block analgesia),with 39 cases in each group.The intraoperative anesthetic dosage,fluid intake and output,Numerical Pain Scale(NRS)score,postoperative ambulation,first exhaust,hospital stay and rescue analgesia were counted and compared between the two groups.The incidence of adverse reactions in the two groups was recorded.Results The intraoperative dosage of remifentanil in the observation group was(1465.85±480.26)μg less than that in the control group,and the difference was statistically significant(t=2.662,P<0.05).The pain scores of the observation group at 2 h,4 h,8 h,12 h and 24 h after operation were all lower than those of the control group,and the first exhaust and the time to get out of bed after operation were shorter than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided continuous TAP block has a significant analgesic effect in patients undergoing open radical resection of rectal cancer,can promote early postoperative recovery,reduce adverse reactions,and has high safety.

关 键 词：镇痛 自控静脉 连续TAP阻滞 开腹直肠癌手术 

分 类 号：R614[医药卫生—麻醉学]