腹横肌平面阻滞对小儿疝气手术中血流动力学、循环指标及苏醒期躁动的影响  

Effect of Transversus Abdominis Plane Block on Hemodynamics,Circulatory Indexes and Restlessness during Recovery in Children with Hernia Surgery

作　　者：赵琳[1] 马新刚[1] ZHAO Lin;MA Xin'gang(Department of Anesthesiology,Zibo Maternal and Child Health Hospital,Zibo,Shandong Province,255000 China)

机构地区：[1]淄博市妇幼保健院麻醉科,山东淄博255000

出　　处：《中外医疗》2023年第13期37-41,共5页China & Foreign Medical Treatment

基　　金：淄博市科技发展计划项目(2016kj010029)。

摘　　要：目的探讨腹横肌平面阻滞对小儿疝气手术中血流动力学、循环指标及苏醒期躁动的影响。方法方便选取2021年1月—2022年6月淄博市妇幼保健院麻醉科收治的114例疝气患儿作为研究对象,按照随机数表方法分为对照组及腹横肌平面阻滞(transversus abdominis plane block,TAPB)组,各57例,对照组采用喉罩全身麻醉,TAPB组在全身麻醉下进行腹横肌平面阻滞。观察两组患儿血流动力学及循环指标、苏醒期躁动评分(PAED)、东大略儿童医院疼痛评分(CHEOPS)。结果与对照组相比,TAPB组T1及T2时PaO_(2)水平(233.40±52.20)mmHg、(240.05±54.03)mmHg均升高,PaCO_(2)水平(40.52±8.38)mmHg、(42.51±9.30)mmHg均降低,差异有统计学意义(t=4.110、4.027、3.846、3.687,P<0.05);与对照组相比,TAPB组T1、T2及T3时MAP降低,T2时SBP降低,T3时DBP降低,差异有统计学意义(P<0.05);与对照组相比,TAPB组各时间点苏醒躁动评分均降低,差异有统计学意义(P<0.05);与对照组相比,TAPB组患儿术后6、24 h的CHEOPS的评分均降低,差异有统计学意义(P<0.05)。结论腹横肌平面阻滞可减少小儿疝气术中血流波动,并显著改善PaO_(2)及PaCO_(2)水平,在降低术后患儿苏醒躁动的同时发挥较强的镇痛作用。Objective To investigate the effect of transversus abdominis plane block on hemodynamics,circulatory indexes and restlessness in children with hernia surgery.Methods A total of 114 children with hernia admitted to Department of anaesthesiology of Zibo Maternal and Child Health Hospital from January 2021 to June 2022 were conveniently selected as the study objects,and were divided into control group and transversus abdominis plane block(TAPB)group according to random number method,with fiftyseven cases in all.The control group received laryngeal mask general anesthesia,TAPB group received transversus abdominis plane block under general anesthesia.The hemodynamic and circulatory indexes,awakening anxiety scale(PAED),Eastern Ontario Children's Hospital Pain Score(CHEOPS)of the two groups were observed.Results Compared with the control group,the PaO_(2) levels in the TAPB group at T1 and T2(233.40±52.20)mmHg and(240.05±54.03)mmHg were increased,PaCO_(2) level(40.52±8.38)mmHg and(42.51±9.30)mmHg were decreased,the difference was statistically significant(t=4.110,4.027,3.846,3.687,P<0.05).Compared with the control group,the MAP were decreased at T1,T2 and T3 in the TAPB group,the SBP was decreased at T2,the DBP was decreased at T3,the difference was statistically significant(P<0.05).Compared with the control group,awake agitation scores at all time point in the TAPB group were decreased,the difference was statistically significant(P<0.05).Compared with the control group,the scores of CHEOPS at 6 h and 24 h after surgery were decreased,the difference was statistically significant(P<0.05).Conclusion Transversus abdominis block can reduce the fluctuation of blood flow during the operation of pediatric hernia,and significantly improve the level of PaO_(2) and PaCO_(2).It can reduce the postoperative recovery agitation of children and play a strong analgesic effect.

关 键 词：患儿 疝气 腹横肌平面阻滞 全麻 血流动力学 循环指标 苏醒期躁动 

分 类 号：R656.21[医药卫生—外科学]