腹横筋膜平面阻滞与椎旁神经阻滞用于妇科腹腔镜手术患者术后镇痛的效果及安全性比较  

Comparison of the effect and safety of TAPB and PVB for postoperative analgesia in gynecologic laparoscopic surgery patients

作　　者：彭通 Peng Tong(Department of Anesthesiology,Nanchong Central Hospital(Beijing Anzhen Hospital Nanchong Hospital),Sichuan 637000,China)

机构地区：[1]四川省南充市中心医院(北京安贞医院南充医院)麻醉科,637000

出　　处：《山西医药杂志》2025年第4期248-251,共4页Shanxi Medical Journal

摘　　要：目的探讨腹横筋膜平面阻滞(TAPB)与椎旁神经阻滞(PVB)用于妇科腹腔镜手术患者术后镇痛的效果及安全性分析。方法选择本院于2021年9月至2023年10月收治的136例妇科腹腔镜手术患者,利用随机数字表发分组法,随机将其分为PVB组和TAPB组,每组68例。PVB组采取PVB方法进行镇痛,TAPB组采取TAPB方法进行镇痛。观察PVB组和TAPB组阻滞起效时间、阻滞持续时间、颈动脉自控镇静(PCIA)按压次数、镇静程度(Ramsay镇静评分)、疼痛程度[视觉模拟评分(VAS)]及不良反应情况。结果TAPB组妇科腹腔镜手术患者阻滞持续时间高于PVB组,且PCIA按压次数和不良反应发生率低于PVB组,差异均有统计学意义(P<0.05);术后3 h、术后24 h、术后48 h时TAPB组妇科腹腔镜手术患者Ramsay高于PVB组,VAS低于PVB组,差异有统计学意义(P<0.05);TAPB组和PVB组阻滞起效时间相比差异无统计学意义(P>0.05)。结论相较PVB,应用TAPB可延长妇科腹腔镜手术患者术后阻滞持续时间,减少患者镇痛药物使用频率,显著降低术后患者疼痛程度,并避免不良反应发生,镇痛效果及安全性均属良好。Objective To investigate the efficacy and safety of abdominal transverse fascial plane block(TAPB)and paravertebral nerve block(PVB)in postoperative analgesia in gynecological laparoscopic surgery.Methods A total of 136 gynaecological laparoscopic surgery patients admitted to our hospital from September 2021 to October 2023 were randomly divided into a PVB group and a TAPB group by stratified randomized grouping method,with 68 cases in each group.The PVB group was used for analgesia,and the TAPB group was used for analgesia.The onset time of the block,duration of the block,patient-controlled intravenous analgesia(PCIA)compression times,sedation degree[Ramsay sedation score],pain degree[visual analogue score(VAS)]and adverse reactions were observed in the PVB group and TAPB group.Results The duration of block in the TAPB group was significantly higher than that of the PVB group,and the frequency of PCIA compression and the incidence of adverse reactions were lower than that of the PVB group,the differences were statistically significant(P<0.05).Ramsay in the TAPB group was higher than the PVB group and VAS was lower than the PVB group at 3 h,24 h and 48 h after surgery,the difference was statistically significant(P<0.05).There was no significant difference in the onset time of the block between the TAPB group and the PVB group(P>0.05).Conclusion Compared with PVB,the application of TAPB can prolong the duration of postoperative block in gynecologic laparoscopic surgery patients,reduce the frequency of the use of analgesic drugs in patients,significantly reduce the degree of pain in postoperative patients and avoid the occurrence of adverse reactions,and the analgesic effect and safety are both good.

关 键 词：腹横筋膜平面阻滞 镇痛效果 妇科腹腔镜手术 椎旁神经阻滞 不良反应 

分 类 号：R614[医药卫生—麻醉学]