双侧腹横肌平面阻滞、腹直肌鞘阻滞联合全身麻醉在腹腔镜胆囊切除术中的应用效果分析  

Analysis of Application Effect of Bilateral Transversus Abdominis Plane Block and Rectus Sheath Block Combined with General Anesthesia in Laparoscopic Cholecystectomy

作　　者：丁君 夏海燕 孙睿 张静 张立东[1] Ding Jun;Xia Haiyan;Sun Rui;Zhang Jing;Zhang Lidong(Department of Anesthesiology,The First People's Hospital of Taicang,Taicang 215400,Jiangsu Province,China)

机构地区：[1]太仓市第一人民医院麻醉科,江苏太仓215400

出　　处：《中国社区医师》2025年第4期15-17,共3页Chinese Community Doctors

摘　　要：目的:分析双侧腹横肌平面阻滞(TAPB)、腹直肌鞘阻滞(RSB)联合全身麻醉在腹腔镜胆囊切除术中的应用效果。方法:选取2023年6月—2024年6月于太仓市第一人民医院行腹腔镜胆囊切除术的患者86例作为研究对象,依据抽签法随机分为对照组和观察组,每组43例。对照组实施全身麻醉,观察组在对照组基础上实施双侧TAPB、RSB。比较两组术后恢复质量、疼痛程度、不良反应发生情况。结果:术后2d,两组术后恢复质量评分高于术后1 d(P<0.05);术后1、2d,观察组术后恢复质量评分高于对照组(P<0.05)。术后2、12、24、48h,两组静息状态、活动状态疼痛评分逐渐降低(P<0.05)。术后2、12、24h,观察组静息状态、活动状态疼痛评分均低于对照组(P<0.05);术后48h,两组静息状态、活动状态疼痛评分比较,无统计学差异(P>0.05)。观察组不良事件总发生率低于对照组(P=0.035)。结论:TAPB复合RSB在腹腔镜胆囊切除术中的应用效果显著,可提高恢复质量,减轻患者疼痛,减少不良事件。Objective:To analyze the application effect of bilateral transversus abdominis plane block(TAPB)and rectus sheath block(RSB)combined with general anesthesia in laparoscopic cholecystectomy.Methods:A total of 86 patients who underwent laparoscopic cholecystectomy in the First People's Hospital of Taicang from June 2023 to June 2024 were selected as the study subjects.They were randomly divided into control group and observation group by drawing lots,with 43 cases in each group.The control group received general anesthesia,and the observation group received bilateral TAPB and RSB on the basis of the control group.The postoperative recovery quality,pain degree and adverse reactions were compared between the two groups.Results:On 2 d after surgery,the postoperative recovery quality scores in the two groups were higher than those on 1 d after surgery(P<0.05).On 1 d and 2 d after surgery,the postoperative recovery quality scores in the observation group were higher than those in the control group(P<0.05).At 2 h,12 h,24 h and 48 h after surgery,the scores of pain at resting state and active state in the two groups gradually decreased(P<0.05).At 2 h,12 h and 24 h after surgery,the scores of pain at resting state and active state in the observation group were lower than those in the control group(P<0.05).At 48 h after surgery,there was no statistical difference in the scores of pain at resting state and active state between the two groups(P>0.05).The total incidence of adverse events in the observation group was lower than that in the control group(P=0.035).Conclusion:The application of TALB combined with RSB has remarkable effects in laparoscopic cholecystectomy,and can improve the recovery quality,relieve the pain of patients and reduce adverse events.

关 键 词：双侧腹横肌平面阻滞 腹直肌鞘阻滞 全身麻醉 腹腔镜胆囊切除术 

分 类 号：R614[医药卫生—麻醉学]