摘要
目的探讨超声引导下腹横肌平面阻滞(TAPB)在腹腔镜下宫颈癌根治术中的应用效果。方法选择石家庄市第四医院2018年3月至2020年3月就诊并在腹腔镜下行宫颈癌根治术治疗的患者120例,将其分为对照组和观察组,每组60例。两组患者均行全身麻醉,观察组患者于麻醉后切皮之前在超声引导下行双侧TAPB。比较两组患者各时间[进入手术室(T1)、实施麻醉(T2)、切皮(T3)、术中探查牵拉(T4)、术毕(T5)]的生命体征指标[平均动脉压(MAP)、心率、脉搏血氧饱和度(SpO_(2))]、不同时间点血浆白细胞介素-6(IL-6)水平、镇痛药的补药次数、手术时间和麻醉后离院评分系统(PADSS)≥9分的时间、术后疼痛评分及不良反应发生率。结果两组患者T1时的MAP及心率均明显高于其他时间(P<0.05);观察组患者T2、T3、T4、T5的MAP及心率比较差异无统计学意义(P>0.05);对照组患者T4时的MAP、心率明显高于T2、T3、T5(P<0.05),且明显高于同时间点的观察组(P<0.05)。两组患者各时间点的SpO_(2)水平比较差异无统计学意义(P>0.05)。两组患者术后即刻及术后24 h的IL-6水平比较,差异有统计学意义(P<0.05);术前及术后48 h的IL-6水平比较差异无统计学意义(P>0.05)。与对照组比较,观察组麻醉补救次数较少、手术时间较短、术后2 h视觉模拟评分(VAS)较低,差异均有统计学意义(P<0.05)。两组患者PADSS≥9分的时间、不良反应发生率比较差异无统计学意义(P>0.05)。结论超声引导下TAPB在腹腔镜下宫颈癌根治术患者中应用可获得更好的麻醉效果,且术后疼痛较轻,安全性较高。
Objective To explore the application effect of ultrasound-guided transverse abdominal muscle plane block(TAPB)in laparoscopic radical resection of cervical cancer.Methods One hundred and twenty patients with laparoscopic radical cervical cancer surgery in the Shijiazhuang Municipal Fourth Hospital from March 2018 to March 2020 were selected and divided into the control group and observation group,60 cases in each group.The two groups underwent general anesthesia.The observation group underwent the ultrasound-guided bilateral TAPB after anesthesia before skin incision.The vital signs indicators[mean arterial pressure(MAP),heart rate,pulse SpO_(2) anaesthesia]at each time points[entering the operating room(T1),implementing anesthesia(T2),skin incision(T3),intraoperative exploratory traction(T4),and the operation end(T5)],plasma interleukin-6(IL-6)level,analgesic drug supplement times,operation time,and time in postanesthetie discharge scoring system(PADSS)≥9 points,postoperative pain score and incidence rate of adverse reactions were compared between the two groups.Results MAP and heart rate at T1 in the observation group and control group were significantly higher than those at other time points(P<0.05);MAP and heart rate in the observation group had no statistical difference among T2,T3,T4 and T5(P>0.05).MAP and heart rate at T4 in the control group were significantly higher than those at T2,T3 and T5(P<0.05),moreover which were higher than those at the same time point in the observation group(P<0.05).There was no statistically significant difference in SpO_(2) at each time point between the two groups(P>0.05).The IL-6 level instantly after operation and at postoperative 24 h had statistical difference between the two groups(P<0.05).The IL-6 level before operation and at postoperative 24 h had no statistically significant difference between the two groups(P>0.05).Compared with the control group,the observation group had fewer times of anesthesia supplement,shorter operation time,and lower VAS score at postopera
作者
马晓俞
申华素
王平
吴振
MA Xiaoyu;SHEN Huasu;WANG Ping;WU Zhen(Department of Anesthesiology,Shijiazhuang Municipal Fourth Hospital,Shijiazhuang,Hebei 050000,China;Department of Anesthesiology,Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)
出处
《重庆医学》
CAS
2021年第23期4058-4061,共4页
Chongqing medicine
基金
河北省石家庄市科学技术研究与发展指导计划(181201393)。
关键词
超声引导
腹横肌平面阻滞
腹腔镜
宫颈癌根治术
安全性
ultrasound-guided
transverse abdominal muscle plane block
laparoscope
radical resection of cervical cancer
safety
