腹横肌平面阻滞对妇科开腹手术患者全身麻醉后早期恢复的临床研究  

Effect of transverse abdominal plane block on early recovery after general anesthesia in patients undergoing gynecological laparotomy

作　　者：韩彬[1,2] 颜飞 严军[2] HAN Bin;YAN Fei;YAN Jun(The First Affiliated Hospital of Xi’an Medical University,Xi’an 710077,China;不详)

机构地区：[1]西安医学院第一附属医院,陕西西安710077 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《陕西医学杂志》2022年第10期1256-1258,1262,共4页Shaanxi Medical Journal

基　　金：陕西省科技厅一般项目-青年项目(2020JQ-511)。

摘　　要：目的:评估腹横肌平面(TAP)阻滞对妇科开腹手术患者全身麻醉早期恢复的作用。方法:50例接受开腹手术的妇科患者,随机分为TAP阻滞组(T组,n=25)和对照组(C组,n=25),分别给予0.5%罗哌卡因20 ml和安慰剂(0.9%氯化钠溶液20 ml)。所有患者接受标准化的全身麻醉及麻醉后监测治疗室(PACU)管理方案。记录术中瑞芬太尼、丙泊酚的需要量及术后拔管时间;PACU停留时间及舒芬太尼、托烷司琼的需要量。结果:46例患者完成实验,T组25例,C组21例。术中瑞芬太尼的消耗量T组明显少于C组(P<0.001),术后拔管时间T组明显短于C组(P=0.026);PACU停留时间T组明显短于C组(P<0.001),舒芬太尼需要量T组明显少于C组(P<0.001),其余指标两组间比较无统计学差异(P>0.05)。结论:TAP阻滞能够减少术中和PACU期间阿片类药物的需要量,促进妇科开腹手术患者全身麻醉早期恢复。Objective:To assess the effect of transverse abdominal plane(TAP) block on early recovery after general anesthesia in patients undergoing gynecological laparotomy.Methods:A total of 50 patients undergoing gynecological laparotomy were randomly divided into TAP block group(group T,25 cases) and control group(group C,25 cases),and 20 ml of 0.5% ropivacaine and 20 ml of 0.9% sodium chloride solution were given respectively.All patients received a standardized general anesthesia and post-anesthesia monitoring treatment unit(PACU) management protocol.Intraoperative requirements of remifentanil and propofol and postoperative extubation time,PACU residence time and sufentanil and tropisetron requirements were recorded.Results:Forty-six patients completed the experiment,25 in group T and 21 in group C.Remifentanil consumption in group T was significantly less than that in group C(P<0.001),extubation time in group T was significantly shorter than that in group C(P=0.026),PACU residence time in group T was significantly shorter than that in group C(P<0.001),sufentanil requirement in group T was significantly less than that in group C(P<0.001),and other indexes were not statistically different between the two groups(all P>0.05).Conclusion:TAP block can reduce opioid requirements during operation and PACU,and promote early recovery of general anesthesia in patients undergoing gynecological laparotomy.

关 键 词：腹横肌平面阻滞 妇科开腹手术 全身麻醉 瑞芬太尼 早期恢复 麻醉后监测治疗室 

分 类 号：R614[医药卫生—麻醉学]