两种不同镇痛方式用于腹腔镜卵巢囊肿剥除术的比较研究  

Comparative study of two different analgesia methods for laparoscopic ovarian cystectomy

作　　者：杨光 高满海[1] YANG Guang;GAO Manhai(The First Affiliated Hospital of Baotou Medical College,Baotou 014010,China)

机构地区：[1]包头医学院第一附属医院,内蒙古包头014010

出　　处：《包头医学院学报》2024年第12期49-53,共5页Journal of Baotou Medical College

基　　金：内蒙古自治区高等学校科学研究项目(NJZY23094)。

摘　　要：目的:探讨静脉全身麻醉分别联合硬膜外阻滞与超声引导腹横肌平面阻滞对腹腔镜卵巢囊肿剥除术患者术后镇痛与早期康复的影响。方法:选择期行腹腔镜卵巢囊肿剥除术患者100例,ASA分级Ⅰ级或Ⅱ级,采用随机数字表法分为腹横肌平面阻滞镇痛组(A组,n=50)和硬膜外阻滞镇痛组(B组,n=50)。比较两组患者阻滞镇痛的操作时间,在麻醉恢复室的停留时间,出手术室前、术后2 h、4 h、8 h、12 h、24 h的VAS评分,抢救镇痛药的使用情况,术后饮食恢复时间,术后首次下床活动时间,术后头痛、呕吐、恶心、低血压发生情况,医患满意度。结果:A组的阻滞镇痛操作时间短于B组(P<0.05)。两组在麻醉恢复室的停留时间差异无统计学意义(P>0.05)。B组在术后2 h、术后8 h、术后12 h、术后24 h的VAS评分低于A组(P<0.05)。B组抢救镇痛药使用率低于A组(P<0.05)。两组术后饮食恢复时间,术后首次下床活动时间差异无统计学意义(P>0.05)。除低血压外,两组术后头痛、恶心、呕吐发生情况差异无统计学意义(P>0.05)。B组医患满意度高于A组(P<0.05)。结论:对于全麻腹腔镜卵巢囊肿剥除术的患者,联合硬膜外阻滞的镇痛效果和镇痛时间要优于联合腹横肌平面阻滞;但两者对术后早期康复的影响很小。Objective:To investigate the effects of intravenous general anesthesia combined with epidural block and ultrasound-guided transversus abdominis plane block on postoperative analgesia and early rehabilitation in patients undergoing laparoscopic ovarian cystectomy.Methods:One hundred patients undergoing laparoscopic ovarian cystectomy,ASA grade I or II,were randomly divided into transversus abdominis plane block analgesia group(group A,n=50)and epidural block analgesia group(group B,n=50).The operation time of block analgesia,the residence time in the anesthesia recovery room,the VAS scores before and 2 h,4 h,8 h,12 h and 24 h after operation,the use of rescue analgesics,the recovery time of diet after operation,the time of first getting out of bed after operation,the occurrence of headache,vomiting,nausea and hypotension after operation,and the patient satisfaction were compared between the two groups.Results:The operation time of block analgesia in group A was shorter than that in group B(P<0.05).There was no significant difference in residence time in anesthesia recovery room between the two groups(P>0.05).The VAS scores of group B at 2 h,8 h,12 h and 24 h after operation were lower than those of group A(P<0.05).The usage rate of rescue analgesics in group B was lower than that in group A(P<0.05).There was no significant difference in postoperative diet recovery time and the first time to get out of bed after operation between the two groups(P>0.05).Except for hypotension,there was no significant difference in the incidence of postoperative headache,nausea and vomiting between the two groups(P>0.05).The patient satisfaction of group B was higher than that of group A(P<0.05).Conclusion:For patients undergoing laparoscopic ovarian cystectomy under general anesthesia,the analgesic effect and analgesic time of combined epidural block are better than those of combined transversus abdominis plane block;however,both have little effect on early postoperative rehabilitation.

关 键 词：硬膜外阻滞 腹横肌平面阻滞 腹腔镜 卵巢囊肿 术后镇痛 术后早期康复 

分 类 号：R614[医药卫生—麻醉学]