腹横筋膜平面阻滞与腹横肌平面阻滞对腹腔镜子宫切除术患者阿片类药物用量及应激反应的影响  

Effects of transverse abdominal fascia plane block and transverse abdominal muscle plane block on opioid dosage and stress response in patients undergoing laparoscopic hysterectomy

作　　者：鲍文珑 袁娜平 涂文娟 BAO Wenlong;YUAN Naping;TU Wenjuan(Department of Gynecology,Third People's Hospital of Yichun City,Yichun,Jiangxi,336000,China;Department of Gynecology,People's Hospital of Fengcheng City,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市第三人民医院妇科,江西宜春336000 [2]丰城市人民医院妇科,江西宜春336000

出　　处：《当代医学》2024年第13期69-72,共4页Contemporary Medicine

摘　　要：目的探讨腹横筋膜平面阻滞与腹横肌平面阻滞对腹腔镜子宫切除术患者阿片类药物用量及应激反应的影响。方法选取2020年1月至2021年12月丰城市人民医院接受腹腔镜子宫切除术的70例患者作为研究对象,按照随机数字表法分为对照组与观察组,每组35例。所有患者均行超声引导下采取神经阻滞、腹腔镜子宫切除术,对照组于术后行双侧腹横肌平面阻滞,观察组于术后行腹横筋膜平面阻滞。比较两组阿片类药物用量(术后24、48 h内阿片类药物用量)、补救镇痛率和手术前后40项恢复质量评分量表(QoR-40)评分、炎症因子[白细胞介素(IL)-6,IL-8]水平及不良反应发生率。结果观察组术后24、48 h内阿片类药物用量均少于对照组,差异有统计意义(P<0.05);观察组补救镇痛率为5.71%,低于对照组的22.86%,差异有统计意义(P<0.05)。术后,两组QoR-40评分均低于术前,但观察组高于对照组,差异有统计意义(P<0.05)。术后1 d,两组IL-6、IL-8水平均高于术前1 d,但观察组低于对照组,差异有统计意义(P<0.05)。观察组不良反应发生率为17.12%,低于对照组的39.97%,差异有统计意义(P<0.05)。结论与术后行腹横肌平面阻滞相比,对行腹腔镜子宫切除术患者术后开展腹横筋膜平面阻滞镇痛效果更理想,可减少阿片类药物用量,改善炎症反应,提高患者恢复质量,降低补救镇痛率及不良反应发生率。Objective To explore the effect of transverse abdominal fascia plane block and transverse abdominal muscle plane block on opioid dosage and stress response in patients undergoing laparoscopic hysterectomy.Methods 70 patients who underwent laparoscopic hysterectomy at Fengcheng People's Hospital from January 2020 to December 2021 were selected as the study subjects,they were divided into the control group and the observation group according to the random number table method,with 35 cases in each group.All patients underwent ultrasound-guided nerve block and laparoscopic hysterectomy,the control group underwent bilateral transverse abdominis muscle plane block after surgery,while the observation group underwent transverse abdominal fascial plane block after surgery.The opioid dosage(opioid dosage within 24 and 48 h after surgery),rescue analgesia rate,and 40-items quality of recovery score(QoR-40)scores,the levels of inflammatory factors(interleukin[IL]-6,IL-8)before and after surgery and the incidence of adverse reactions were compared between the two groups.Results The opioid dosage within 24 and 48 h after surgery in the observation group was less than those in the control group,the differences were statistically significant(P<0.05);the remedial analgesia rate in the observation group was 5.71%,which was lower than 22.86%in the control group,the difference was statistically significant(P<0.05).After surgery,the QoR-40 score of the two groups was lower than that before surgery,but the observation group was higher than the control group,and the difference was statistically significant(P<0.05).At 1 d after surgery,the levels of IL-6 and IL-8 of the two groups was higher than those at 1 d before surgery,but the observation group were lower than the control group,and the differences were statistically significant(P<0.05).The adverse reaction rate in the observation group was 17.12%,which was lower 39.97%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with transverse a

关 键 词：腹腔镜子宫切除术 腹横肌平面阻滞 腹横筋膜平面阻滞 

分 类 号：R614[医药卫生—麻醉学]