摘要
目的观察超声引导下椎板阻滞对腹腔镜胆囊切除术患者围手术期镇痛的安全性和有效性。方法选取2019年6月至2020年6月民航总医院行腹腔镜胆囊切除术患者60例,按随机数字法将患者分为椎板阻滞组和对照组,每组30例。椎板阻滞组在麻醉诱导前行超声引导下椎板阻滞,对照组直接行麻醉诱导,两组患者的麻醉诱导和术中麻醉管理相同。比较两组入室、气腹前、气腹后10 min、术毕、术后2 h的平均动脉压(MAP)和心率(HR),手术时间及术中镇痛药用量,术后2、6、24 h的视觉模拟评分(VAS),术后24 h内镇痛药用量、使用者比例和恶心呕吐发生率的差异。结果两组患者入室、气腹前、气腹后10 min、术毕、术后2 h的MAP、HR、手术时间、术中舒芬太尼和瑞芬太尼用量的差异均无统计学意义。与对照组相比,椎板阻滞组患者术后2、6 h的VAS评分降低,差异均有统计学意义(P<0.05)。两组术后24 h VAS评分的差异无统计学意义。与对照组比较,椎板阻滞组术后镇痛药地佐辛用量和使用者所占比例明显减少,差异均有统计学意义(P<0.05)。两组患者术后恶心呕吐发生率的差异无统计学意义。结论超声引导下椎板阻滞不影响腹腔镜胆囊切除术患者术中血流动力学变化,但能有效缓解术后6 h内的疼痛。
Objective To observe the safety and effectiveness of perioperative analgesia with ultrasound-guided retrolaminar block during laparoscopic cholecystectomy.Methods A total of 60 patients who underwent laparoscopic cholecystectomy in the Civil Aviation General Hospital from June 2019 to June 2020 were selected and divided into retrolaminar block group and control group by random number method.Patients in the retrolaminar block group underwent ultrasound-guided retrolaminar block before induction of anesthesia,and the control group underwent induction of anesthesia directly.Indicators included the amount of sufentanil and remifentanil in the two groups during the operation;MAP and HR at the entrance,just before pneumoperitoneum,10 minutes after pneumoperitoneum,just after the operation,and 2 hours after operation;VAS pain scores at 2,6,and 24 h after operation,the amount of dezocine within 24 hours after operation,and the incidence of complications such as nausea and vomiting within 24 hours after operation.Results Compared with the control group,the retrolaminar block group reduced the patients’VAS pain scores at 2 and 6 h after the operation(P<0.05),and the dosage and usage rate of dezocine at 24 h after the operation were significantly reduced in the retrolaminar block group(P<0.05).There were no statistical differences in other observation indicators.Conclusion Ultrasound-guided retrolaminar block does not cause the hemodynamic changes during laparoscopic cholecystectomy,and effectively relieves the pain of patients within 6 h after operation.
作者
桑本玲
高国林
刘秀峰
Sang Benling;Gao Guolin;Liu Xiufeng(Department of Anesthesiology,the Civil Aviation General Hospital,Beijing 100123,China)
出处
《中华普通外科学文献（电子版）》
CAS
2022年第2期122-126,共5页
Chinese Archives of General Surgery(Electronic Edition)
基金
民航总医院院级项目(201923)。
关键词
超声引导
椎板阻滞
腹腔镜胆囊切除术
疼痛
Ultrasound-guided
Retrolaminar block
Laparoscopic cholecystectomy
Pain
