摘要
目的观察超声引导下的腹横肌平面阻滞(transversus abdominis plane block,TAPB)在腹腔镜结直肠癌根治术患者麻醉指导中的应用价值。方法选取平顶山市第二人民医院2020年8月至2022年8月行根治术治疗的113例结直肠癌患者为研究对象。采用抽签法,将患者分为试验组57例和对照组56例,对照组术中实施常规全麻,试验组采用超声引导下的TAPB辅助全麻,比较两组患者的临床指标、术后镇痛情况、术前术后体征指标波动、术后苏醒质量及不良事件发生情况。结果在不同麻醉方案下,试验组麻醉维持时的瑞芬太尼用药量、术后麻醉苏醒时间、自控镇痛泵(PCA)停用时间均低于对照组,术后1、3、5、7 h的视觉模拟疼痛(VAS)评分低于对照组,术前术后心率(HR)、收缩压(SBP)、舒张压(DBP)、血氧饱和度(SaO2)等指标差值低于对照组,苏醒后Riker镇静躁动评分(SAS)、Ramsay镇静评分高于对照组,不良事件发生率7.02%(4/57)低于对照组17.86%(10/56),P<0.05。结论超声引导下的TAPB可有效指导腹腔镜下根治术的全麻用药,对缩短患者术后苏醒、拔管及PCA应用时间有积极作用,可在增强结直肠癌根治术患者的术后镇痛效果同时维持术后体征并改善苏醒质量,还可降低不良事件发生风险。
Objective To observe the value of ultrasound-guided transversus abdominis plane block(TAPB)in guiding anesthesia in colorectal cancer patients undergoing laparoscopic radical resection.Methods Totally 113 colorectal cancer patients undergoing laparoscopic radical resection visited Pingdingshan Second People's Hospital from August 2020 to August 2022 were enrolled.The patients were assigned to the control group(n=56)and the test group(n=57)by a drawing lots,in which they were given routine general anesthesia during the operation and under-ultrasound TAPB,respectively.The pre-post-operative clinical indicators,analgesia,signs fluctuation,recovery quality and adverse events were compared between the two groups.Results The dosage of remifentanil,the time of recovery from anesthesia,the stopping time of patient-controlled analgesia(PCA)in the test group were lower than those in the control group.Visual analogue scale(VAS)for pain at 1,3,5,and 7 hours postoperatively in the test group was lower than that in the control group,and the pre-post-operative differences of heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and blood oxygen saturation(SaO2)were lower than those in the control group,Riker sedation agitation scale(SAS)score and Ramsay sedation score after awakening were higher than those in the control group,and the incidence of adverse events in the test group was lower than that in the control group[7.02%(4/57)VS 17.86%(10/56),P<0.05].Conclusion Ultrasound-guided TAPB can effectively guide the drug application of general anesthesia in laparoscopic radical resection,shorten postoperative recover,extubation time and PCA application time of patients.For colorectal cancer patients undergoing laparoscopic radical resection,it can not only enhance postoperative analgesia,maintain postoperative signs,and improve the quality of recovery,but also reduce the risk of adverse events.
作者
陈午光
王梦
CHEN Wu-guang;WANG Meng
出处
《中国疗养医学》
2023年第5期532-535,共4页
Chinese Journal of Convalescent Medicine
基金
河南省医学科技攻关项目(LHGJ2021002165),超声引导下TAPB在腹腔镜结直肠癌患者根治术中的麻醉应用价值研究。
关键词
结直肠癌根治术
腹横肌平面阻滞
全身麻醉
麻醉指导
Radical resection of colorectal cancer
Transversus abdominis plane block
General anesthesia
Anesthesia guidance
