摘要
目的:探讨腹横肌平面阻滞联合舒芬太尼对腹腔镜阑尾切除术患者术后镇痛的影响。方法:选取瑞金市人民医院麻醉科2021年8月—2023年7月收治的94例行腹腔镜阑尾切除术患者,按照随机数字表法将所有患者分为试验组(n=47)、对照组(n=47)。试验组术毕实施双侧腹横肌平面阻滞+舒芬太尼自控镇痛,对照组术毕采用舒芬太尼自控镇痛。观察两组舒芬太尼用量、术后首次下地时间和进食时间,术后视觉模拟评分法(VAS)评分,以及炎症反应指标和不良反应发生情况。结果:试验组舒芬太尼用量少于对照组,术后首次下地时间、进食时间均早于对照组(P<0.05)。试验组术后12、24、36 h VAS评分均低于对照组(P<0.05)。术后3 d两组TNF-α、CRP水平均升高,试验组TNF-α、CRP水平均低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:腹横肌平面阻滞联合舒芬太尼应用于腹腔镜阑尾切除术后患者,镇痛作用显著,还可减轻炎症反应。
Objective:To investigate the effect of transversus abdo-minal plane block combined with Sufentanil on postoperative analgesia in patients undergoing laparoscopic appendectomy.Method:A total of 94 patients who underwent laparoscopic appendectomy in Department of Anesthesiology,People's Hospital of Ruijin City from August 2021 to July 2023 were selected,and all patients were divided into experimental group(n=47)and control group(n=47)according to random number table method.The experimental group was treated with transversus abdo-minal plane block+Sufentanil controlled analgesia after surgery,and the control group was treated with Sufentanil controlled analgesia after surgery.The dosage of Sufentanil,the first time of postoperative landing and feeding,the postoperative visual analogue scale(VAS)score,the inflammatory response indexes and the occurrence of adverse reactions were observed in the two groups.Result:The dosage of Sufentanil in experimental group was less than that in control group,and the first time of postoperative landing and feeding were shorter than those in control group(P<0.05).VAS scores at 12,24 and 36 h after surgery in experimental group were lower than those in control group(P<0.05).The levels of tumor necrosis factor-α(TNF-α)and C reactive protein(CRP)were increased in both groups 3 d after surgery,and the levels of TNF-αand CRP in experimental group were lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of transversus abdo-minal plane block combined with Sufentanil in patients after laparoscopic appendectomy has significant analgesic effect and can also reduce inflammatory response.
作者
杨健发
王俊晖
邓媛
应美红
张朝阳
YANG Jianfa;WANG Junhui;DENG Yuan;YING Meihong;ZHANG Chaoyang(Department of Anesthesiology,People's Hospital of Ruijin City,Ruijin 342500,China;不详)
出处
《中国医学创新》
CAS
2024年第17期37-40,共4页
Medical Innovation of China
关键词
腹腔镜阑尾切除术
腹横肌平面阻滞
舒芬太尼
镇痛
Laparoscopic appendectomy
Transversus abdo-minal plane block
Sufentanil
Analgesiat
