摘要
目的:探讨超声引导下腰方肌阻滞联合全麻对腹腔镜子宫肌瘤剔除术中血流动力学及镇痛效果的影响。方法:选取2017年3月至2019年3月在天门市第一人民医院行腹腔镜子宫肌瘤剔除术的患者200例,随机分为对照组和观察组,每组100例。对照组给予全凭静脉麻醉处理,观察组超声引导下腰方肌阻滞后再行全麻处理,比较两组不同时刻血流动力学[平均动脉压(MAP)、心率(HR)]、全麻用药量、苏醒质量、不良反应。结果:观察组切皮时(T1)、肌瘤剔除时(T2)、术毕(T3)的MAP、HR明显低于对照组(P<0.05);观察组全麻用药量、镇痛泵用量及有效按压次数明显少于对照组,呼之睁眼时间、气管导管拔管时间、恢复室停留时间明显短于对照组,躁动率明显低于对照组(P<0.05);观察组和对照组不良反应率比较,差异无统计学意义(P>0.05)。结论:超声引导下腰方肌阻滞联合全麻可有效改善腹腔镜子宫肌瘤剔除术中血流动力学及镇痛效果,有利于改善患者苏醒质量,且安全性好,值得临床推广。
Objective: To investigate the effects of ultrasound-guided quadratus lumborum block combined with general anesthesia on hemodynamics and analgesia in laparoscopic myomectomy.Methods: 200 patients who underwent laparoscopic myomectomy in The first people’s Hospital of Tianmen in Hubei Province from March2017 to March 2019 were randomly divided into control group and observation group,with 100 cases in each group.The patients in the control group were received total intravenous anesthesia,and the patients in the observation group were treated with ultrasound-guided quadratus lumborum block followed by general anesthesia.The hemodynamics(mean arterial pressure,MAP;heart rate,HR),dosage of general anesthesia,awakening quality,and adverse reactions were compared between the two groups at different times point.Results: The MAP and HR during skin incision(T1),myomectomy(T2),and after operation(T3)in the observation group were significantly lower than those in the control group(P<0.05).The dosage of general anesthesia,analgesia pump,and effective pressing times in the observation group were significantly less than those in the control group,and the eye opening time,tracheal extubation time,and recovery room stay time in the observation group were significantly shorter than those in the control group,and the restlessness rate in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the rate of adverse reactions between the observation group and the control group(P>0.05).Conclusion: Ultrasound-guided quadratus lumborum block combined with general anesthesia can effectively improve the hemodynamics and analgesic effects in laparoscopic myomectomy,which is helpful to improve the awakening quality of patients with great safety.It is worthy for clinical popularization.
作者
乔克坤
李向
向志雄
Qiao Kekun;Li Xiang;Xiang Zhixiong(The first people’s hospital of Tianmen in Hubei Province,Tianmen 431700,China)
出处
《广西医科大学学报》
CAS
2020年第4期751-755,共5页
Journal of Guangxi Medical University
关键词
超声引导
腰方肌阻滞
全麻
腹腔镜子宫肌瘤剔除术
血流动力学
镇痛效果
ultrasound-guided
quadratus lumborum block
general anesthesia
laparoscopic myomectomy
hemodynamics
analgesia effect
