摘要
目的探讨超声引导下罗哌卡因在腹横肌平面(TAP)阻滞对妇科腹腔镜手术患者麻醉用药与术后镇痛效果方面的影响。方法 60例妇科腹腔镜手术患者,随机分为两组,每组30例,分别为:静脉镇痛组(V组)和腹横肌平面阻滞组(T组)。T组在诱导时行双侧腹横肌平面阻滞,每侧注射0.4%罗哌卡因15 m L,而V组仅在术毕静脉镇痛,采用2 ug/kg舒芬太尼加入0.9%氯化钠液体稀释到100 m L静脉镇痛。记录入室时、切皮前、切皮后5min、10 min、60 min、术毕各时间点的HR、MAP以及术毕舒芬太尼、七氟醚用量,记录术后有无恶心呕吐等不良反应。记录术后6、12、24 h时和视觉模拟评分(VAS)和舒适度评分(BCS)。结果与V组相比,T组切皮前、切皮后5 min和10 min的MAP和HR显著降低(P<0.05),术毕舒芬太尼和七氟醚用量减少(P<0.05),术后6、12、24 h VAS评分降低以及各时间点BCS升高(P<0.05),术后不良反应降低(P<0.05)。结论超声引导下罗哌卡因TAP阻滞既能明显减少妇科腹腔镜手术患者的术中麻醉药物用量,又能增强术后镇痛的疗效,还能降低术后不良反应的发生,显著提高患者的舒适度。
Objective To investigate the effect of ropivacaine transversus abdominis plane block on the anesthesia and postoperative analgesia in patients with gynecological laparoscopic surgery. Methods Sixty patients with gynecologic laparoscopic surgery were randomly divided into two groups： 30 patients in each group： venous analgesia group （V group） and abdominal transverse plane block group （ group T）. T group at the time of induction of bilateral abdominal transverse plane block, each side of the injection of 0.4% ropivacaine 15 mL, and V group only intravenous analgesia after the surgery, with 2 ug/kg sufentanil added 0.9% chlorination Sodium liquid was diluted to 100 mL intravenous analgesia. HR, MAP and the amount of sufentanil and sevoflurane were recorded before anesthesia induction, before surgery, at 5 min, 10 rain, 60 min after skin incision, and no adverse reactions such as nausea and vomiting were recorded. The visual acuity score （VAS） and comfort score （BCS） were recorded at 6, 12, 24 hours postoperatively. Results Compared with V group, MAP and HR were significantly decreased （P 〈 0.05） before surgery, at 5 min and 10 min after T, and the dosage of sufentanil and sevoflurane was decreased （P 〈0. 05）. The VAS score decreased at 6, 12, 24 h after operation and BCS increased at each time point （P 〈 0. 05 ）, and the postoperative adverse reactions were decreased （ P 〈 0. 05 ）. Conclusion Ultrasound - guided TAP blockade of ropivacaine can significantly reduce the dosage of intraoperative narcotic drugs in gynecologic laparo- scopic surgery patients, but also enhance the effect of postoperative analgesia and reduce the incidence of postoperative ad- verse reactions, and increase satisfaction of patients.
出处
《现代医院》
2017年第6期907-909,共3页
Modern Hospitals
基金
吉安市2016年度指导性科技计划项目(编号:吉市科计字[2016]4号)
关键词
罗哌卡因
腹横肌平面阻滞
腹腔镜
妇科
Ropivacaine
Abdominal Transverse Plane Block
Laparoscopic
Gynecology
