CAJ | 학술논문

目的：观察超声引导下腹横肌平面（TAP）阻滞应用于小儿腹腔镜下疝囊高位结扎手术术后的镇痛效果。方法择期拟行腹腔镜下疝囊高位结扎术的患儿60例，随机分为T组和L组，T组给予超声引导下TAP阻滞联合喉罩通气全麻、L组单纯喉罩全麻。记录术中瑞芬太尼的用量；记录停止注射药物后患者的苏醒时间；记录术后2 h、4 h、8 h和24 h的疼痛视觉模拟评分（VAS）评分。记录术后48 h的经静脉自控镇痛（PCIA）的有效按压次数。结果 T组患儿术后2 h、4 h的VAS评分低于L组差异有统计学意义（P＜0.05）；与L组比较，T组患儿瑞芬太尼用量明显减少，差异有统计学意义（P＜0.05）、术后48 h PCIA有效按压次数明显减少（P＜0.05）。结论在小儿腹腔镜疝囊高位结扎术中应用超声引导下TAP阻滞，可以为术后早期提供良好的镇痛。
목적：관찰초성인도하복횡기평면（TAP）조체응용우소인복강경하산낭고위결찰수술술후적진통효과。방법택기의행복강경하산낭고위결찰술적환인60례，수궤분위T조화L조，T조급여초성인도하TAP조체연합후조통기전마、L조단순후조전마。기록술중서분태니적용량；기록정지주사약물후환자적소성시간；기록술후2 h、4 h、8 h화24 h적동통시각모의평분（VAS）평분。기록술후48 h적경정맥자공진통（PCIA）적유효안압차수。결과 T조환인술후2 h、4 h적VAS평분저우L조차이유통계학의의（P＜0.05）；여L조비교，T조환인서분태니용량명현감소，차이유통계학의의（P＜0.05）、술후48 h PCIA유효안압차수명현감소（P＜0.05）。결론재소인복강경산낭고위결찰술중응용초성인도하TAP조체，가이위술후조기제공량호적진통。
Objective To observe the post operative analgesia effect transverse abdominal plane (TAP) block guided by ultrasound applying to pediatric laparoscopic surgery. Methods 60 case of children schduled for elective inguinal hernia repair were randomLy divided into two groups (group T and group L each group has 30 cases).Group T:TAP block combined with laryngeal mask anesthesia;group L:simple laryngeal mask anesthesia. Records of the consumption of remifentanil used during operation,statistics awakening time from stop drug injection. Record postoperative 2 ,4 , 8 and 24h pain visual analogue scale (VAS) score;Record effective pressing PCIA 48 h after operation. Results Group T VAS score less than Group L in 2、4 postoperation (P<0.05), Group T consumption of remifentanil markably reduced(P<0.05), 48 h postoperative PCIA effective pressing numbers decreased signiifcantly (P<0.05) compared with group L. Conculusion TAP block guided by ultrasound in pediatric laparoscopic surgery, it can provide good analgesia for early postoperative.