腹横肌平面阻滞联合氟比洛芬酯和右美托咪定静脉自控镇痛对腹腔镜全子宫切除术术后康复的影响  

Effect of Transversus Abdominis Plane Block Combined with Flurbiprofen Axetil and Dexmedetomidine Intravenous Patient-Controlled Analgesia on Postoperative Rehabilitation After Laparoscopic Total Hysterectomy

作　　者：杨秀娥 李国建[1] 刘明明 岑璐君 王智华 YANG Xiu'e;LI Guojian;LIU Mingming;CEN Lujun;WANG Zhihua(Guangdong Shunde Xinrongqi Hospital Co.,Ltd.Foshan,Guangdong 528300)

机构地区：[1]广东顺德新容奇医院有限公司,广东佛山528300

出　　处：《智慧健康》2024年第35期42-44,48,共4页Smart Healthcare

基　　金：2021年佛山市卫生健康局《腹横肌平面阻滞联合氟比洛芬酯和右美托咪定静脉自控镇痛对腹腔镜全子宫切除术术后康复的影响》(项目编号:20220272)。

摘　　要：目的探讨应用腹横肌平面(TAP)阻滞联合氟比洛芬酯和右美托咪定静脉自控镇痛(PCIA)对行腹腔镜全子宫切除术患者术后康复的影响。方法选取2022年1月—2023年7月收治的60例择期行腹腔镜全子宫切除术的患者为研究对象,并随机分成观察组和对照组,每组30例。其中,对照组应用PCIA泵1(舒芬100μg+右美托咪定100μg+昂丹司琼8 mg);观察组应用TAP阻滞+PCIA泵2(氟比洛芬酯200 mg+右美托咪定100μg+昂丹司琼8 mg)。对比两组患者术后疼痛、康复及不良反应。结果观察组术后4 h、8 h、24 h的VAS评分显著低于对照组(P<0.05);观察组患者首次下床活动时间短于对照组,术后24 h的Ramsay镇静评分与QoR-40评分高于对照组,术后镇痛泵自控次数少于对照组(P<0.05);两组术后不良反应发生率无差异(P>0.05)。结论对于行腹腔镜全子宫切除术的患者,术后行TAP阻滞联合氟比洛芬酯和右美托咪定PCIA可取得良好镇痛效果,加快患者术后恢复速度且不良反应少。Objective To investigate the effect of transversus abdominis plane(TAP)block combined with flurbiprofen axetil and dexmedetomidine intravenous patient-controlled analgesia(PCIA)on postoperative rehabilitation of patients with laparoscopic full-automatic resection.Methods The paper chose 60 patients and divided them into the observation group and the control group randomly,with 30 cases in each group.The control group was treated with PCIA pump 1(Shufen 100μg+Dexmedetomidine 100μg+Ondansetron 8 mg),and the observation group with TAP blockade and PICIA pump 2(200 mg flurbiprofen ester+100μg dexmedetomidine+8mg ondansetron).Postoperative pains,recovery and adverse reactions were compared between two groups.Results The VAS scores of the observation group were significantly lower than the control group at 4,8 and 24 hours after surgery(P<0.05).The observation group had shorter first out of bed time than the control group,Ramsay sedation scores and QoR-40 scores were higher than the control group 24 hours after surgery.Number of postoperative analgesia pump self-control times was less than the control group(P<0.05).There was no significant difference in incidence of postoperative adverse reactions between two groups(P>0.05).Conclusion Postoperative TAP block combined with flurbiprofen axetil and dexmedetomidine PCIA can achieve good analgesic effect,accelerate postoperative recovery speed of patients with laparoscopic total hysterectomy,which has fewer adverse reactions.

关 键 词：腹腔镜全子宫切除术 腹横肌平面阻滞 氟比洛芬酯 右美托咪定 静脉自控镇痛 

分 类 号：R61[医药卫生—外科学]