超声引导下腹横肌平面阻滞复合静脉麻醉在老年腹股沟疝修补术中的应用效果观察  

Application effect of ultrasound-guided transverse abdominal plane block combined with intravenous anesthesia for inguinal hernia repair in elderly patients

作　　者：王全亮[1] 包楚肖 WANG Quan-liang;BAO Chu-xiao(Department of Anesthesiology,Sihong County People's Hospital,Suqian 223900,China)

机构地区：[1]泗洪县人民医院麻醉科,223900

出　　处：《中国实用医药》2022年第18期90-92,共3页China Practical Medicine

摘　　要：目的 分析老年腹股沟疝修补术中超声引导下腹横肌平面(TAP)阻滞复合静脉麻醉的应用效果。方法 50例老年腹股沟疝修补术患者,按随机数字表法分为观察组和对照组,各25例。观察组采用超声引导下TAP阻滞复合静脉麻醉,对照组采用腰硬联合麻醉。对比两组患者不同时间点[进入手术室(T0)、麻醉后5 min(T1)、手术30 min(T2)和出手术室(T3)]血流动力学指标[平均动脉压(MAP)与心率(HR)],不良反应发生率,术后6、12、24 h疼痛评分,镇痛泵按压次数及下床活动时间。结果 T0时,两组HR、MAP对比差异无统计学意义(P>0.05);T1、T2、T3时,观察组HR、MAP均高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为4.00%,低于对照组的32.00%,差异有统计学意义(P<0.05)。术后6、12、24 h,观察组疼痛评分低于对照组,差异有统计学意义(P<0.05)。观察组镇痛泵按压次数(5.21±1.06)次少于对照组的(6.95±2.15)次,下床活动时间(3.26±1.15)h早于对照组的(4.95±1.62)h,差异有统计学意义(P<0.05)。结论 对于老年腹股沟疝修补术患者采用超声引导下TAP阻滞复合静脉麻醉可有效提升麻醉质量,有助于维持患者术中血流动力学平稳,改善术后镇痛,并降低不良反应发生率。Objective To analyze the application effect of ultrasound-guided transverse abdominal plane(TAP) block combined with intravenous anesthesia for inguinal hernia repair in elderly patients. Methods A total of 50 elderly patients with inguinal hernia repair were divided into observation group and control group according to random numerical table, with 25 cases in each group. The observation group was treated with ultrasound-guided TAP block combined with intravenous anesthesia, and the control group was treated with combined spinal-epidural anesthesia. Both groups were compared in terms of hemodynamic indicators [mean arterial pressure(MAP)] and heart rate(HR) at different time points [when entering the operating room(T0), 5 min after anesthesia(T1),30 min after surgery(T2), and when leaving the operating room(T3)], the incidence of adverse reactions, pain scores at 6, 12, and 24 h postoperatively, the number of analgesic pump pressings and off-bed activity time.Results At T0, there was no statistically significant difference in HR and MAP between the two groups(P>0.05).At T1, T2, and T3, the HR and MAP in the observation group were higher than those in the control group, and the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group was 4.00%, which was lower than 32.00% in the control group, and the difference was statistically significant(P<0.05). At 6, 12, and 24 h postoperatively, the pain scores of the observation group was lower than those of the control group, and the differences were statistically significant(P<0.05). The number of analgesic pump pressings(5.21±1.06) times in the observation group was less than(6.95±2.15) times in the control group, and the off-bed activity time(3.26±1.15) h was earlier than(4.95±1.62) h in the control group. All the differences were statistically significant(P<0.05). Conclusion For elderly patients undergoing inguinal hernia repair, ultrasound guided TAP block combined with intravenous anesthesia can effectively im

关 键 词：超声引导 腹横肌平面阻滞 静脉麻醉 腹股沟疝修补术 老年 

分 类 号：R614[医药卫生—麻醉学]