摘要
目的探讨丙泊酚复合右美托咪定腹横纹肌平面阻滞对肝切除术(PHX)治疗的影响。方法选取单县中心医院2020年7月-2022年5月收治的109例行PHX治疗的患者为研究对象,按照两组患者麻醉方案差异分组,其中对照组(n=52)、观察组(n=57)。前者单纯全麻,后者全麻联合丙泊酚复合右美托咪定横纹肌平面阻滞。对比两组麻醉后疼痛变化、术后肝功能差异、应急指标及麻醉苏醒质量。结果观察组术后6h、术后12h、术后24h时视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。术后1d两组患者谷丙转氨酶、谷草转氨酶对比差异不显著(P>0.05);术后14d观察组上述指标水平低于对照组(P<0.05)。术后1d两组患者平均动脉压、心率对比差异不显著(P>0.05);术后14d观察组平均动脉压、心率均低于对照组(P<0.05)。拔管即刻两组改良警觉-镇静量表(0AA/S)评分、苏醒室标准(Aldrete)评分对比差异不显著(P>0.05);拔管30min时两组0AA/S、Aldrete评分对比差异不显著(P>0.05)。术后观察组躁动等不良事件发生率低于对照组(P<0.05)。结论丙泊酚复合右美托咪定横纹肌平面阻滞可有效缓解PHX术后疼痛,为术后康复打下坚实基础,促进患者肝功能的改善,能够帮助患者保持血压、心率的稳定,提升麻醉苏醒质量。
Objective To investigate the effect of propofol combined with dexmedetomidine abdominal-striated plane block on the treatment of hepatectomy(PHX).Methods A total of 109 patients treated with PHX in our hospital from July 2020 to May 2022 were selected as the research objects.According to the difference of anesthesia protocol between the two groups,the control group(n=52)and the observation group(n=57)were divided into two groups.The former was simply under general anesthesia,while the latter was combined with propofol and dexmedetomidine for striated muscle plane block.The changes of postoperative pain,postoperative liver function,emergency indicators and quality of anesthesia recovery were compared between the two groups.Results The visual analogue scale(VAS)of the observation group was lower than that of the control group at 6h,12h and 24h after operation,and the difference was statistically significant(P<0.05).There was no significant difference in alanine aminotransferase and aspartate aminotransferase between the two groups one day after operation(P>0.05).The above indexes in the observation group were lower than those in the control group 14 days after operation(P<0.05).There were no significant differences in mean arterial pressure and heart rate between the two groups one day after operation(P>0.05).The mean arterial pressure and heart rate of the observation group were lower than those of the control group 14 days after operation(P<0.05).There was no significant difference in modified Alert-Sedation scale(OAA/S)score and Aldrete score between the two groups immediately after extubation(P>0.05).There were no significant differences in OAA/S and Aldrete scores in the observation group at 30 minutes after extubation(P>0.05).The incidence of agitation in the observation group was lower than that in the control group(P<0.05).Conclus ions Propofol combined with dexmedetomidine striated muscle plane block can effectively relieve postoperative pain after PHX,lay a solid foundation for postoperative rehabilitatio
作者
孙秋艳
Sun Qiuyan(Shanxian Central Hospital,Heze,Shandong 274300,China)
出处
《首都食品与医药》
2022年第23期79-81,共3页
Capital Food Medicine
关键词
肝切除术
丙泊酚
右美托咪定
腹横纹肌平面阻滞
镇痛
肝功能
Hepatectomy
Propofol
Dexmedetomidine
Abdominal-striated muscle plane block
Analgesia
Liver function
