不同入路腹横肌平面阻滞在老年患者腹股沟疝修补术手术中的应用效果

摘要

目的 探讨不同入路腹横肌平面阻滞(TAPB)在腹股沟疝修补术中的麻醉效果.方法 选取2014年1月至2016年1月于榆林第一医院择期行腹股沟疝修补术的老年患者74例,按照随机数表法分为腋前线组及肋下缘组各37例,分别行腋前线TAPB和肋下缘TAPB.观察两组患者术后2、6、12、24及48小时疼痛视觉模拟评分(VAS)及躁动-镇静评分(RASS),麻药用量、麻醉苏醒时间、手术持续时间及术后并发症.结果 术后各时点两组患者VAS及RASS评分差异均无统计学意义(P>0.05).麻醉苏醒时间分别为(15.16±6.72)min和(16.08±6.11)min,但差异无统计学意义(P>0.05),两组患者镇痛满意度均达到85%以上且差异无统计学意义(P>0.05).结论 腋前线与肋下缘两种入路TAPB在老年患者腹股沟疝修补术中麻醉效果相同.%Objective To compare the analgesic effects of different approachesof transversus abdominis plane block (TAPB)in those elderly patientsreceivinginguinal hernia repair .Methods 74 elderly patients,underwent electiveoperationsof inguinal hernia repairin our hos -pital between Jan 2014 and Jan 2016, werecollected andequallydivided into two groupsby means of random number table (n =37).Patients in the two groups wereanaesthetized by TAPBvia anterior axillary line approachorsubcostal approach ,respectively,and then were operated.Thep-ain scores of visual analoguescale (VAS) and scores of Richmond agitation sedationscale (RASS) at the time of 2, 6, 12, 24, 48 hours after operation,together with dosage of anesthetics , recovery timefromanesthesia, operation timeandpostoperativecomplications betweenthe two groups wereobservedand compared .Results The VAS and RASSscores at eachtime point werenotsignificantlydifferentbetween the two groups (all P >0.05).The recovery time from anesthesiain the two groups were (15.16 ±6.72)minand(16.08 ±6.11) min,respectively,with no significant difference(P >0.05).The satisfactionrates of analgesia in the patientsofboth groupswereall above 85%, and theirdifferenceswereof no significance(P >0.05).Conclusion The analgesic effectsof TAPB via anterior axillary line approach or subcostal approachwere all satis -fied forthose elderly patients receiving inguinal hernia repair .