超声引导腹横肌平面阻滞对无张力疝修补术后患者疼痛及生存质量的影响被引量：14

Effect of ultrasound-guided transversus abdominis plane block on postoperative pain and quality of life of patients after tension-free hernioplasty

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摘要目的评价腹横肌平面阻滞对无张力疝修补患者术后疼痛及生存质量的影响。方法选择在我院拟行无张力疝修补术患者140例,随机分为腹横肌平面阻滞组(TAP-B)和静脉自控镇痛组(PCIA),每组70例。观察两组患者术后急慢性疼痛水平并记录术后住院日,镇痛相关的不良事件,EQ-5D健康指数量表。结果与PCIA组相比,TAP-B组术后24、48、72 h运动NRS评分显著降低(P<0.05),静息NRS评分差异无统计学意义(P>0.05);与PCIA组相比,TAP-B组术后第3,6个月静息,运动NRS评分,CPSP发生率降低,EQ-5D分值明显升高(P<0.05)。与PCIA组相比,TAP-B组患者术后住院日明显减少,恶心呕吐,补救镇痛明显减少(P<0.05)。结论 TAP-B能够有效减轻无张力疝修补术的术后疼痛,有效降低术后早,中期CPSP和病理性疼痛的发生率,提高患者生存质量。 Objective To evaluate the effect of transversus abdominis plane block on the postoperative acute,chronic pain and quality of life of patients with tension-free hernioplasty.Methods 140 patients with tension-free hernioplasty were randomly divided into TAP-B group and PCIA group.The numerical rating scale(NRS)with rest state and activity state in patients after 24,48,72 hours and 3,6,12 months were recorded respectively.The two groups were compared in terms of incidence rate of chronic postoperative pain after 3,6,12 months and hospital day,EQ-5D health index scale scores and analgesia related adverse events.Results Compared with PCIA group,the activity NRS score at hours 24,48,72 in TAP-B group was significantly lower(P<0.05),but there was no significant difference in rest NRS score(P>0.05).Compared with PCIA group,the NRS score at months 3 and 6,incidence of CPSP and EQ-5D score in TAP-B group were significantly lower(P<0.05),but there was no significant difference between the two groups at the time point of 12 month(P>0.05).Compared with PCIA group,the average stay,nausea and vomiting and remedial analgesia in the TAP-B group were signifi-cantly lower(P<0.05).Conclusion TAP-B can reduce postoperative pain and have fewer adverse reactions for patients with tension-free hernioplasty,and improve the patients′quality of life.

作者牟俊英赵博袁泉王雅枫刘恋夏中元 MOU Junying;ZHAO Bo;YUAN Quan;WANG Yafeng;LIU Lian;XIA Zhongyuan(Department of Anesthesiology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区武汉大学人民医院麻醉科

出处《实用医学杂志》 CAS 北大核心 2018年第15期2541-2543,2547,共4页 The Journal of Practical Medicine

基金湖北省自然科学基金(编号:2017CFB267) 中央高校基本科研业务费专项基金(编号:2042017kf0147)

关键词超声腹横肌平面阻滞无张力疝修补术术后疼痛 ultrasound transversus abdominis plane block tension-free hernioplasty postoperative pain

分类号 R614 [医药卫生—麻醉学]

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参考文献2

1田雪,安海燕,冯艺.超声引导下腹横肌平面阻滞用于腹股沟疝成形术病人术后镇痛的效果[J].中华麻醉学杂志,2013,33(3):275-278. 被引量：47
2董盛龙,朱少飞,林赛娟,王卡.超声引导腹横肌平面阻滞对结肠癌开腹手术患者循环应激及术后镇痛的影响[J].实用医学杂志,2017,33(2):259-262. 被引量：45

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