超声引导下腹横肌平面阻滞在子宫切除术患者的应用

摘要

目的：评价超声引导下腹横肌平面阻滞（T A PB ）在子宫切除术患者的应用价值。方法120例子宫全切术患者随机均分为TAPB＋静脉患者自控镇痛（PCA）组（T组）和静脉PCA组（C组）。T组术毕采用0.3％罗哌卡因50 ml行双侧 TAPB ，术后行静脉 PCA ，配方为舒芬太尼1.5μg／kg和托烷司琼5 mg ，加生理盐水至100 ml。C组术后静脉PCA配方为舒芬太尼3.0μg／kg和托烷司琼5 mg ，加生理盐水至100 ml。记录两组术后4、8、24 h的VAS疼痛评分和肛门排气时间，观察不良反应发生情况。结果两组各时间点VAS 评分差异无统计学意义。T组术后恶心呕吐发生率低于C组（P＜0．05），肛门排气时间短于C组（P＜0．05）。结论超声引导下 TAPB技术可以加速子宫切除术患者的康复。%Objective To investigate the application value of ultrasound‐guided transversus abdominis plane block (TAPB) in the patients undergoing hysterectomy .Methods One hundred and twenty patients undergoing hysterectomy under general anesthesia were equally and randomly divided into two groups of T and C .Ultrasound‐guided bilateral TAPB with 0.3% ropivacaine 50 ml was performed in group T at the end of surgery .Both groups received intravenous patient‐controlled analgesia(PCA) after operation .Analgesic solution consisted of sufentanil 1.5μg/kg in normal saline 100 ml for group T and sufentanil 3.0μg/kg in normal saline 100 ml for group C .VAS pain score was evaluated at 4 ,8 ,24 hours after operation .The anal exhaust time and adverse effects were recorded as well .Results There were no significant differences in VAS pain scores at 4 ,8 ,24 hours after operation between two groups(P>0 .05) .The incidences of postoperative nausea and vomiting were less in group T than those in group C(P<0 .05) .The anal exhaust time was earlier in group T than that in group C(P<0 .05) .Conclusion Ultrasound‐guided TAPB is able to speed up the recovery of patients undergoing hysterectomy .