摘要
目的探讨罗哌卡因腹横肌平面阻滞(TAPB)联合患者自控静脉镇痛(PCIA)在腹外疝术后的镇痛效果。方法选取本院于2019年7月至2021年9月收治的行腹外疝术患者94例作为研究对象,随机分为两组。对照组(47例)术后给予PCIA镇痛方法,研究组(47例)术后在对照组基础上联合罗哌卡因TAPB镇痛。比较两组患者一般情况、术后2、6、12、24、48 h疼痛评分[视觉模拟评分法(VAS)]和镇静评分(Ramsay评分)、PCIA按压总次数和输注总量以及不良反应。结果两组性别、年龄、体重、手术时间等一般情况比较差异无统计学意义(P<0.05);两组术后2、6、12、24、48 h VAS评分均先升高后下降(P<0.05),Ramsay评分均逐渐下降(P<0.05),且研究组术后6、12、24、48 h VAS评分均低于对照组(P<0.05),但以上时间点Ramsay评分比较差异均无统计学意义(P<0.05);研究组术后48 h PCIA按压总次数和输注总量均更少(P<0.05),两组不良反应总发生率比较差异无统计学意义(P<0.05)。结论罗哌卡因TAPB联合PCIA相比单独使用PCIA在腹外疝术后的镇痛效果更加显著,能够减少PCIA按压总次数和输注量,且安全性良好。
Objective To investigate the analgesic effect of ropivacaine transverse abdominal muscleplane block(TAPB)combined with patient-controlled intravenous analgesia(PCIA)after surgical treatment for external abdominal hernia.Methods A total of 94 patients undergoing abdominal external hernia surgery in our hospital from July 2019 to September 2021 were selected as study subjects and randomly divided into two groups.The control group(47 patients)received PCIA postoperatively,while the study group(47 patients)received additional ropivacaine TAPB analgesia on the basis of the control group.The general condition,pain scores[visual analog scale(VAS)]and sedation scores(Ramsay scale)at 2 h,6 h,12 h,24 h and 48 h after surgery,total number of PCIA compression,total amount of infusion,and adverse reactions were comparedbetweenthe two groups.Results There were no differences in gender,age,bodyweight,andsurgical duration between the two groups(P>0.05).The VAS scores increased initially and then decreased at 2 h,6 h,12 h,24 h and 48 h postoperativelyin both groups(P<0.05).Ramsay scores decreased gradually(P<0.05).VAS scores at 6 h,12 h,24 h and 48 h were lower in the study group than in the control group(P<0.05),but there were no differences in Ramsay scores at the above time points(P>0.05).The total number of PCIA compression and total amount of infusion were smaller in the study group 48 h after surgery(P<0.05).There was no difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusions Ropivacaine TAPB combined with PCIA has a more significant analgesic effect than PCIA alone after surgical treatment for abdominal external hernia.This combined therapycan reduce the total number of PCIA compressionand amount of infusion volumeand it has bettersafety.
作者
王鑫
王露
WANG Xin;WANG Lu(Xuzhou Central Hospital,Xuzhou 221009,China)
出处
《实用医学杂志》
CAS
北大核心
2022年第24期3141-3144,共4页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:81700078)。
关键词
罗哌卡因
腹横肌平面阻滞
自控静脉镇痛
腹外疝
手术
镇痛
ropivacaine
transverse abdominal muscle plane block
patient controlled intravenous analgesia
external abdominal hernia
surgery
analgesia
