摘要
目的探讨超声引导下右侧星状神经节阻滞(SGB)对腹腔镜胆囊切除术(LC)患者术后内脏痛与恶心呕吐(PONV)的影响。方法选取择期行LC的患者120例,采用随机数字表法分为SGB组60例和对照组60例。SGB组于术前行超声引导下右侧SGB,注入1%利多卡因6 mL,对照组于相同部位注入等量生理盐水,2组术毕均用1%罗哌卡因10 mL局部浸润腹部切口。记录2组患者麻醉诱导前(T_(0))、插管即刻(T_(1))、切皮时(T_(2))、气腹建立时(T_(3))、气腹建立后10 min(T_(4))、术毕(T_(5))的平均动脉压(MAP)和心率(HR)。记录术后0.5、4、12、24 h的内脏痛数字评价量表(NRS)评分,术后24 h内PONV发生情况及止吐药物使用情况。分别记录2组手术时间、术中丙泊酚和瑞芬太尼用量、拔管时间、术后第1次肛门排气时间、术后第1晚阿森斯失眠量表(AIS)评分、麻醉满意度评分。结果与对照组比较,SGB组MAP和HR在T_(1)、T_(4)时均明显降低(P<0.05)。与对照组比较,SGB组术后4 h、12 h内脏痛NRS评分明显降低,术后24 h内PONV发生率明显降低且止吐药物使用率降低(P<0.05)。SGB组患者术后第1次肛门排气时间更早,术后第1晚AIS评分更低,麻醉满意度评分更高(P<0.05)。结论超声引导右侧SGB有助于减轻LC术后内脏痛,降低PONV发生率,改善术后睡眠质量。
Objective To investigate the effect of ultrasound-guided right stellate ganglion block(SBG) on postoperative visceral pain and postoperative nausea and vomiting(PONV) in patients undergoing laparoscopic cholecystectomy(LC).Methods A total of 120 patients scheduled for elective LC were divided into the SGB group(n=60)and the control group(n=60) using a random number table.Ultrasound-guided right SGB was conducted with 1% lidocaine 6mL before surgery in the SGB group,and the equal volume of normal saline was given at the same site in the control group.Local infiltration anesthesia at incision site was performed with 1% ropivacaine 10 mL at the end of surgery in both groups.The mean arterial pressure(MAP) and heart rate(HR) were recorded at different time points,including before anesthesia induction(T_(0)),after endotracheal intubation(T_(1)),skin incision(T_(2)),pneumoperitoneum establishment(T_(3)),10 min after pneumoperitoneum establishment(T_(4)) and at the end of surgery(T_(5)).Postoperative visceral pain scores evaluated by the Numerical Rating Scale(NRS) at four times(0.5 h,4 h,12 h,24 h after surgery),incidence of PONV and rate of using antiemetics during the first 24 h after surgery were recorded.The operation time,total dose of propofol and remifentanil,extubation time,first anal exhaust time,Athens Insomnia Scale(AIS) scores on the first night after surgery and satisfaction scores were recorded as well.Results The MAP and HR were significantly lower at T_(1)and T_(4)in the SGB group than those in the control group(P<0.05).Compared with the control group,the SGB group showed lower NRS scores of visceral pain at 4 h and 12 h after surgery,lower incidence of PONV and lower rate of using antiemetics(P <0.05).Meanwhile,earlier first anal exhaust,lower AIS scores on the first night after surgery and higher satisfaction scores were observed in the SGB group(P <0.05).Conclusion Ultrasound-guided right SGB can alleviate postoperative visceral pain in patients after LC,reduce the incidence of PONV and improve the q
作者
黄孝慈
陈齐
盛奎
邵艳梅
汤昕宇
胡宪文
HUANG Xiaoci;CHEN Qi;SHENG Kui;SHAO Yanmei;TANG Xinyu;HU Xianwen(Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes,Department of Anesthesiology and Perioperative Medicine,the Second Hospital of Anhui Medical University,Hefei 230601,China)
出处
《天津医药》
CAS
北大核心
2023年第2期186-190,共5页
Tianjin Medical Journal
基金
安医大二附院-中科院合肥研究院联合基金(LHJJ202004)。
关键词
星状神经节
胆囊切除术
腹腔镜
内脏痛
手术后恶心呕吐
stellate ganglion
cholecystectomy,laparoscopic
visceral pain
postoperative nausea and vomiting
