超声引导下腹横肌平面阻滞联合腹直肌鞘阻滞用于开腹全子宫切除术后镇痛效果  

Postoperative analgesic effect of the ultrasound-guided transverse abdominis plane block combined with the rectus sheath block for total hysterectomy by laparotomy

作　　者：秦华 胡春霞 QIN Hua;HU Chunxia(Huaian Hongze District Hospital of Traditional Chinese Medicine,Huaian,Jiangsu Province,223199)

机构地区：[1]江苏省淮安市洪泽区中医院,223199

出　　处：《中国计划生育学杂志》2025年第1期134-139,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨超声引导下腹横肌平面阻滞(TAPB)联合腹直肌鞘阻滞(RSB)对开腹全子宫切除手术患者术后镇痛效果。方法:选取2023年1月-2024年1月本院收治的行开腹全子宫切除手术的患者110例,随机分为对照组和联合组各55例,两组均采用超声引导下TAPB,联合组加用RSB。比较两组血流动力学指标、镇静情况、疼痛情况、舒适度、镇痛泵按压次数、麻醉满意度及不良反应。结果:联合组心率、平均动脉压水平在不同时间点波动幅度均小于对照组(P<0.05);术后2h、术后12h联合组Ramsay评分(3.76±0.45分、2.07±0.31分)高于对照组(2.37±0.33分、1.65±0.24分),伯格曼舒适度量表(BCS)评分(2.32±0.35分、3.36±0.47分)均高于对照组(1.58±0.26分、2.57±0.38分),数字疼痛评分法(NRS)评分(2.02±0.35分、1.07±0.24分)低于对照组(3.37±0.46分、1.69±0.31分),联合组麻醉满意度评分(20.85±3.08分)高于对照组(18.27±2.36分),镇痛泵按压次数(3.54±0.58次)少于对照组(5.52±0.91次)(均P<0.05);联合组与对照组呕吐、苏醒期躁动等总发生率(12.7%、9.1%)无差异(P>0.05)。结论:对行开腹全子宫切除术式患者采用TAPB联合RSB方案麻醉,可有效减轻患者术后疼痛,提升舒适度,效果较理想,且未增加不良反应。Objective:To exploring the postoperative anesthesic effect of the ultrasound-guided transverse abdominis plane block(TAPB)combined with the rectus abdominis sheath block(RSB)for patients after total hysterectomy by laparotomy.Methods:lio patients who wanted total hysterectomy by laparotomy in the hospital were selected and were randomly divided into two groups(55 cases in each group)from January 2023 to January 2024.The patients in the two groups were given TAPB guided by ultrasound,while the patients in the study group were given RSB additionally.The hemodynamic indicators values,the situations of sedation and pain,the comfort degree,the number of the analgesic pump presses,the anesthesia satisfaction and the adverse reactions rate of the patients were compared between the two groups.Results:The fluctuation ranges of the heart rate and the mean arterial pressure of the patients in the study group at different time points were significantly lower than those of the patients in the control group(P<0.05).The Ramsay scores of the patients in the study group at 2h and 12h after operation were 3.76±0.45 points and 2.07±0.31 points,and which were significantly higher than those(2.37±0.33 points and 1.65±0.24 points)of the patients in the control group.The Bergmann comfort scale(BCS)scores of the patients in the study group at 2h and 12h after operation were 2.32±0.35 points and 3.36±0.47 points,and which were significantly higher than those(1.58±0.26 points and 2.57±0.38 points)of the patients in the control group.The numerical rating scale(NRS)scores of the patients in the study group at 2h and 12h after operation were 2.02±0.35 points and 1.07±0.24 points,and which were significantly lower than those(3.37±0.46 points and 1.69±0.31 points)of the patients in the control group.The anesthesia satisfaction score(20.85±3.08 points)of the patients in the study group was significantly higher than that(18.27±2.36 points)of the patients in the control group.The number of the pressing analgesic pump(3.54±0.58 time

关 键 词：开腹全子宫切除术 超声引导 腹横肌平面阻滞 腹直肌鞘阻滞 术后镇痛 

分 类 号：R47[医药卫生—护理学]