摘要
目的研究超声引导腹横肌平面阻滞(TAPB)联合氢吗啡酮超前镇痛在腹腔镜胆囊切除术(LC)的镇痛效果。方法择期行LC的38例患者随机分为联合组和对照组,每组各19例,两组全麻诱导后超声引导下行双侧TAPB,手术开始前联合组静脉推注氢吗啡酮10μg/kg,对照组注射等量生理盐水,记录两组患者拔管后1h时Price-henry疼痛评分、躁动分级以及Ramsay镇静评分,观察补救性镇痛药的需要例数以及术后静脉自控镇痛(PICA)的按压次数。结果联合组患者Price-henry疼痛评分、躁动评分明显降低,PICA按压次数明显低于对照组(P<0.05);联合组补救性镇痛药的使用率明显低于对照组(P<0.05);两组患者Ramsay镇静评分差异无统计学意义(P>0.05)。结论 TAPB联合氢吗啡酮超前镇痛有助于减轻LC患者围术期疼痛,不影响镇静深度,安全性高、不良反应较少,具有较好的临床应用价值。
Objective To assess the clinical effect of ultrasound-guided transverses abdominis plane block（TAPB） combined with hydromorphone in patients undergoing laparoscopic cholesystectomy（LC）.Methods Totally 38 patients who underwent LC were assinged into control group and combine group randomly （n= 19）.Ultrasound-guided TAPB was practiced after general anesthesia induction and 10 μg/kg hydromorphone was injected before surgery in combine group;The normal saline was injected in control group.The Price-henry pain score,postoperative agitation score and Ramsay score were recored lh after extubation ;The number of postoperative rescue analgesic and compressin number of PICA were recorded as well. Results The Price-henry pain score, postoperative agitation score and compressin number of PCIA in combine group were less than those of control group（P〈0.05）;Compared with control group,the number of postoperative rescue analgesic in combine group was decreased obviously （P 〈 0. 05） ;But there was no significant difference in the Ramsay score between the two groups（P 〉0.05） .Conclusion The preemptive analgesic of ultrasound-guided TAPB combined with hydromorphone can meet the needs of patients, enhance the comfort after surgry and improve pa- tient＇s satisfaction.
出处
《湖北民族学院学报（医学版）》
2016年第1期32-34,共3页
Journal of Hubei Minzu University(Medical Edition)
