超声引导下腹横筋膜平面阻滞应用于妇科急腹症腹腔镜术后镇痛效果分析  

Analysis of the Analgesic Effect of Ultrasound-Guided Transversus Abdominis Plane Block in Postoperative Pain Management After Laparoscopy for Gynecological Acute Abdomen

作　　者：杨勇 杨昌勇 YANG Yong;YANG Changyong(Yinjiang Tujia and Miao Autonomous County People's Hospital Surgical Anesthesiology Department,Tongren 555200,China;Tongren People's Hospital Department of Anesthesiology,Tongren 554300,China)

机构地区：[1]印江土家族苗族自治县人民医院手术麻醉科,贵州铜仁555200 [2]铜仁市人民医院麻醉科,贵州铜仁554300

出　　处：《中华灾害救援医学》2025年第2期177-180,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探讨在妇科急腹症腹腔镜术后的镇痛中,超声引导下腹横筋膜平面阻滞(TFB)的镇痛效果,及与腹横肌平面阻滞(TAPB)的效果比较。方法选取2023年6月至2024年6月印江土家族苗族自治县人民医院收治的行妇科急腹症腹腔镜手术的94例患者为回顾性研究对象。根据术后镇痛方案的不同分为观察组(超声引导下腹横筋膜平面阻滞,47例)和对照组(超声引导下TABP,47例)。比较两组患者术后疼痛程度、镇静程度、镇痛泵按压次数、曲多马用量、不良反应发生情况。结果与对照组患者相比,观察组患者术后8h、12h、24h的术后疼痛程度VAS评分明显更低(P<0.001)。观察组患者术后8h、12h、24h的镇静程度Ramsay评分与对照组无显著差异(P>0.05)。观察组患者术后4h、8h、12h、24h镇痛泵按压次数较对照组更少(P<0.001);观察组患者术后4h、8h、12h、24h曲多马用量较对照组更少(P<0.001)。两组患者不良反应总发生率无显著差异(P>0.05)。结论相较于超声引导下TAPB,超声引导下TFB可降低妇科急腹症腹腔镜术后患者的疼痛程度和麻醉药物的用量,镇静效果佳,安全性较高。Objective This study aims to investigate the analgesic efficacy of ultrasound-guided transversus fascia plane block(TFB)in postoperative pain management for patients undergoing laparoscopic surgery for gynecological acute abdomen,and to compare its effects with those of transversus abdominis plane block(TAPB).Methods A retrospective study was conducted involving 94 patients who underwent laparoscopic surgery for gynecological acute abdomen at the People's Hospital of Yinjiang Tujia and Miao Autonomous County from June 2023 to June 2024.Based on different postoperative analgesic regimens,the patients were divided into two groups:the observation group(ultrasound-guided TFB,47 cases)and the control group(ultrasound-guided TAPB,47 cases).We compared postoperative pain levels,sedation levels,the frequency of patient-controlled analgesia(PCA)pump activations,the dosage of sufentanil administered,and the incidence of adverse reactions between the two groups.Results Compared to the control group,the observation group exhibited significantly lower visual analog scale(VAS)pain scores at 8,12,and 24 hours postoperatively(P<0.001).There were no significant differences in Ramsay sedation scores between the two grou ps at 8,12,and 24 hours postoperatively(P>0.05).The observation group demonstrated fewer PCA pump activations at 4,8,12,and 24 hours postoperatively compared to the control group(P<0.001).Additionally,the dosage of sufentanil used by the observation group was significantly lower at 4,8,12,and 24 hours postoperatively compared to the control group(P<0.001).The overall incidence of adverse reactions did not differ significantly between the two groups(P>0.05).Conclusion Ultrasound-guided TAP block is more effective than ultrasound-guided TAM block in reducing pain severity and anesthetic drug consumption in patients undergoing laparoscopic surgery for gynecological acute abdomen.Furthermore,TAP block provides satisfactory sedation effects and has a high safety profile,making it a technique worth y of promotion.

关 键 词：腹横肌平面阻滞 腹横筋膜平面阻滞 妇科急腹症 

分 类 号：R656.1[医药卫生—急诊医学]