[1]王跃振,梁 皓,田本祎,等.超声引导下腹横肌平面阻滞在老年腹腔镜胆囊切除术中的应用[J].医学信息,2021,34(07):122-124.[doi:10.3969/j.issn.1006-1959.2021.07.033]
　WANG Yue-zhen,LIANG Hao,TIAN Ben-yi,et al.Application of Ultrasound-guided Transversus Abdominis Plane Block in Elderly Laparoscopic Cholecystectomy[J].Medical Information,2021,34(07):122-124.[doi:10.3969/j.issn.1006-1959.2021.07.033]
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超声引导下腹横肌平面阻滞在老年腹腔镜胆囊切除术中的应用()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年07期
页码:
122-124
栏目:
临床研究
出版日期:
2021-04-01

文章信息/Info

Title:
Application of Ultrasound-guided Transversus Abdominis Plane Block in Elderly Laparoscopic Cholecystectomy
文章编号:
1006-1959（2021）07-0122-03
作者:
王跃振; 梁 皓; 田本祎; 等
（鹤岗市人民医院麻醉科，黑龙江 鹤岗 154101）
Author(s):
WANG Yue-zhen; LIANG Hao; TIAN Ben-yi; et al.
(Department of Anesthesiology,Hegang People’s Hospital,Hegang 154101,Heilongjiang,China)
关键词:
腹横肌平面阻滞; 腹腔镜胆囊切除术; 镇痛
Keywords:
Transverse abdominal muscle plane block; Laparoscopic cholecystectomy; Perioperative period
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2021.07.033
文献标志码:
A
摘要:
目的 观察超声引导下肋缘下入路腹横肌平面（TAP）阻滞对老年腹腔镜胆囊切除术（LC）围术期的镇痛作用。方法 选取2019年6月~2020年1月我院ASAⅠ~Ⅱ级LC老年患者40例，随机分为观察组和对照组，各20例，对照组行常规全身麻醉，观察组全身麻醉后行超声引导下行双侧肋缘下TAP阻滞，两组术后均行自控镇痛泵。比较两组术中舒芬太尼用量、拔管时间、术后2、24、48 h静息时VAS疼痛评分、并发症及不良反应发生情况。结果 观察组术中舒芬太尼用量、拔管时间、术后2、24 h静息时VAS疼痛评分均小于对照组，差异有统计学意义（P＜0.05）；术后48 h，两组静息时VAS疼痛评分比较，差异无统计学意义（P＞0.05）；两组穿刺点均未见血肿、皮下渗血等穿刺相关并发症；观察组术后不良反应发生率低于对照组，差异有统计学意义（P＜0.05）。结论 TAP阻滞可减少老年患者全身麻醉下LC术中阿片类药物用量，缩短拔管时间，降低药物不良反应，提高围术期麻醉安全性与术后镇痛效果。
Abstract:
Objective To observe the analgesic effect of ultrasound-guided subcostal approach transversus abdominis plane (TAP) block in the perioperative period of elderly laparoscopic cholecystectomy (LC).Methods From June 2019 to January 2020, 40 elderly patients with ASA I~II LC in our hospital were randomly divided into observation group and control group, with 20 cases in each group. The control group received general anesthesia, and the observation group received ultrasound after general anesthesia. Guided bilateral subcostal TAP block, both groups underwent self-controlled analgesia pump after operation.Intraoperative sufentanil dosage, extubation time, VAS pain score at rest 2, 24, and 48 h after surgery, complications and adverse reactions were compared between the two groups.Results The intraoperative sufentanil dosage, extubation time, and VAS pain scores at rest at 2 and 24 h after the operation in the observation group were lower than those in the control group,the difference was statistically significant (P<0.05);There was no statistically significant difference in the VAS pain scores between the two groups at rest at 48 h after surgery (P>0.05);There were no puncture-related complications such as hematoma and subcutaneous bleeding at the puncture points in the two groups; the incidence of postoperative adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05).Conclusion TAP block can reduce the amount of opioids during LC surgery in elderly patients under general anesthesia, shorten the time of extubation, reduce adverse drug reactions, and improve the safety of perioperative anesthesia and postoperative analgesia.

参考文献/References:

[1]Str MC,Rasmussen LS,Steinmetz J.Practical Management of Anaesthesia in the Elderly[J].Drugs&Aging,2016,33(11):765-777. [2]Molliex S,Passot S,Morel J,et al.A multicentre observational study on management of general anaesthesia in elderly patients at high-risk of postoperative adverse outcomes[J].Anaesth Crit Care Pain Med,2019,38(1):15-23. [3]Jan J,Liselott W,Sune F,et al.Transversus abdominal plane(TAP)block for postoperative pain management:a review[J].F1000research,2015(4):F1000. [4]Ma N,Duncan JK,Scarfe AJ,et al.Clinical safety and effectiveness of transversus abdominis plane(TAP)block in post-operative analgesia:a systematic review and meta-analysis[J].Journal of Anesthesia,2017,31(3):1-21. [5]Tran DQ,Bravo D,Leurcharusmee P,et al.Transversus Abdominis Plane Block:A Narrative Review[J].Anesthesiology,2019,131(5):1166-1190. [6]Altiparmak B,Korkmaz Toker M,Uysal AI,et al.Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy:Randomized,controlled trial[J].Journal of Clinical Anesthesia,2019(57):31-36. [7]Ashok J,Priyanka J,Swastika C,et al.Role of ultrasound guided transversus abdominis plane block as a component of multimodal analgesic regimen for lower segment caesarean section:a randomized double blind clinical study[J].Bmc Anesthesiology,2018,18(1):53. [8]Gao T,Zhang JJ,Xi FC,et al.Evaluation of Transversus Abdominis Plane(TAP)Block in Hernia Surgery:A Meta-analysis[J].Clinical Journal of Pain,2016,33(4):369.

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更新日期/Last Update: 1900-01-01