中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2013, Vol. 42 ›› Issue (11): 1032–1035.

• 论著 • 上一篇    下一篇

超声引导腹横肌平面阻滞对于肝肿瘤患者术中和术后镇痛药物用量的影响

  

  1. 中国医科大学附属第一医院麻醉科,沈阳110001
  • 收稿日期:2013-08-05 出版日期:2013-11-30 发布日期:2013-11-28
  • 作者简介:王以亮(1983-),男,硕士研究生.
  • 基金资助:
    辽宁省科学技术计划项目(2010225034)

Effects of Ultrasound-guided Transverse Abdominis Plane Block on Intraoperative and Postoperative Analgesics Consumption in Patients Undergoing Liver Tumor Resection

WANG Yi-liang,WU Bin-yang,CAO Xue-zhao,LIU ong-tao   

  1. Department of Anesthesiology,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2013-08-05 Online:2013-11-30 Published:2013-11-28

摘要: 目的观察腹横肌平面(TAP)阻滞用于成人肝肿瘤手术患者术中和术后的镇痛效果。方法60例全麻下行开腹肝肿瘤切除术手术患者,随机均分为2组。麻醉诱导后1组行超声引导双侧TAP阻滞,注射0.2%罗哌卡因1.5mg/kg(R组),另一组行常规全身麻醉未行TAP阻滞(C组)。记录2组术中切皮前后血压、心率变化,舒芬太尼用量,术后2、6、12、24及48h视觉模拟疼痛(VAS)评分观察术后镇痛满意度。记录不良反应的发生情况。结果与C组比较,R组切皮时血压、心率波动明显减小(P<0.05);2组患者术后2、6、12h的VAS评分有明显差异,与C组比较,R组VAS明显降低(P<0.05),镇痛满意度较好(P<0.05),2组患者术后24h及48hVAS评分无明显差异;TAP阻滞后,R组术后哌替啶用量明显少于C组(P<0.05);2组均未见血肿、恶心、呕吐、皮肤瘙痒、胸闷等不良反应发生。结论超声引导下TAP阻滞用于肝肿瘤手术能有效镇痛,明显减少术中和术后镇痛药的需要量,增加镇痛效果。

关键词: 超声引导, 腹横肌平面阻滞, 镇痛, 肝肿瘤切除术

Abstract: Objective To observe the effects of ultrasound-guided transverse abdominis plane (TAP) block on intraoperative and postoperative analgesic efficacy in patients undergoing liver tumor resection. Methods Sixty patients scheduled for abdominal liver tumor resection under general anesthesia were randomly divided into 2 groups (n=30 each): ropivacaine group(group R) and matched group(group S). After induction of anesthesia,ultrasound-guided bilateral TAP block was performed and 0.2% ropivacaine (1.5 mg/kg) was injected in group R,while nothing was done in group S. The hemodynamic parameters during skin incision were recorded. The consumption of sufentanil during operation and VAS score at 2,6,12,24 and 48 h after operation and analgesic satisfaction after operation were recorded. The adverse reactions were also recorded.Results Compared with group S,haemodynamic parameters in group R maintain even stable during skin incision (P<0.05); VAS at 2,6,12 h after operation were significantly lower (P<0.05),analgesic satisfaction was better.VAS at 24and 48h after operation were no significant different.

Key words: ultrasound-guided, transverse abdominis plane block, analgesia, liver tumor resection

中图分类号: 

  • R614.2
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