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[1]来 伟,丁国友,孟海兵,等.超声引导改良肋缘下腹横肌阻滞对腹腔镜胆囊切除术术中术后镇痛的影响[J].医学研究与战创伤救治(原医学研究生学报),2015,17(01):32-34.[doi:10.3969/j.issn.1672-271X.2015.01.010]
　LAI Wei,DING Guo-you,MENG Hai-bing,et al.Effects of ultrasound-guided improved subcostal transverse abdominis plane block on intraoperative and postoperative analgesia in patients undergoing laparoscopic cholecystectomy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(01):32-34.[doi:10.3969/j.issn.1672-271X.2015.01.010]
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超声引导改良肋缘下腹横肌阻滞对腹腔镜胆囊切除术术中术后镇痛的影响()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年01期
页码:
32-34
栏目:
出版日期:
2015-01-31

文章信息/Info

Title:
Effects of ultrasound-guided improved subcostal transverse abdominis plane block on intraoperative and postoperative analgesia in patients undergoing laparoscopic cholecystectomy
作者:
来 伟; 丁国友; 孟海兵; 帅 君; 胡 平; 蔡定浩
330002 江西南昌，解放军94医院麻醉科
Author(s):
LAI Wei;  DING Guo-you;  MENG Hai-bing;  SHUAI Jun;  HU Ping;  CAI Ding-hao.
Department of Anesthesiology， 94 Hospital of PLA， Nanchang， Jiangxi 330002， China
关键词:
超声引导; 改良; 腹横肌阻滞; 腹腔镜胆囊切除术; 镇痛
Keywords:
ultrasound-guided;  improved;  TAP block;  laparoscopic cholecystectomy;  analgesic
分类号:
R657.4
DOI:
10.3969/j.issn.1672-271X.2015.01.010
文献标志码:
A
摘要:
目的 探讨超声引导改良肋缘下腹横肌阻滞对腹腔镜胆囊切除术患者术中术后镇痛效果的影响。 方法 全麻下行腹腔镜胆囊切除术60例，随机分为两组。麻醉诱导后一组在超声引导下行改良肋缘下入路的双侧腹横肌平面(TAP)阻滞，注入0.5%罗哌卡因(0.8 mL/kg，A组)，另一组全麻后未行TAP阻滞(B组)。两组术后均应用患者静脉自控镇痛(PCIA)进行镇痛。记录两组手术中瑞芬太尼的用量，手术结束时除去喉罩时的平均动脉压(MAP)和心率(HR)，术后2、6、24 h视觉模拟疼痛(VAS)评分，PCIA泵术后36 h总用药量和自控镇痛有效按压次数及镇痛期间不良反应的发生情况。结果 与B组比较，A组术中瑞芬太尼的用量明显减少(P<0.05)，除去喉罩时MAP、HR波动明显减小(P<0.05)，术后2、6 h VAS评分A组明显低于B组(P<0.05)，PCIA总用药量和有效按压次数A组明显少于B组(P<0.05)，A组镇痛期间不良反应发生也明显少于B组。结论 超声引导改良肋缘下TAP阻滞能为腹腔镜胆囊切除术患者提供良好的术中及术后镇痛。
Abstract:
Objective To investigate the effect of ultrasound-guided improved subcostal transversus abdominis plane (TAP) block on intraoperative and postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Methods Sixty patients undergoing laparoscopic cholecystectomy were randomly allocated into 2 groups (30 cases each):group A and group B. After induction of anesthesia， ultrasound-guided improved subcostal TAP block was performed and 0.5% ropivacaine (0.8 mL/kg) was injected in group A， while nothing was done in group B (matched group). All patients received patient controlled intravenous analgesia (PCIA) after operation. The consumption of remifentanil during operation were recorded. The mean arterial pressure (MAP)， heart rate (HR) were recorded on the end of surgery and the extraction of laryngeal mask (LAM). Pain visual analog scale (VAS) scores at 2， 6， 24 h after operation， the dosage of 36 h patient controlled intravenous analgesia (PCIA) and frequencies of PCIA effective pressing were recorded. The adverse reactions were also recorded. Results Compared with group B， the consumption of remifentanil during operation in group A were significantly lower (P<0.05)， the MAP and HR in group A maintain even stable during the extraction of LAM (P<0.05)， VAS at 2， 6 h after operation were significantly lower (P<0.05). The dosage of 36 h PCIA and the frequencies of PCIA effective pressing of group B were much more than those of group A (all P<0.05)， the adverse reactions in group B were significantly higher than those in group A (P<0.05). Conclusion By using ultrasound-guided improved subcostal TAP block can provided a better intraoperative and postoperative analgesic efficacy in patients undergoing laparoscopic cholecystectomy.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2015-01-20