CAJ | 학술논문

目的探讨腹横肌平面(transverse abdominis plane,TAP)阻滞对老年患者腹腔镜腹股沟疝修补术术后镇痛效果的影响. 方法选择行腹腔镜腹股沟疝修补术的老年患者40例,按照随机数字表法分为观察组(A组)和对照组(B组),每组20例.全身麻醉诱导完成后超声引导下实施患侧TAP阻滞,A组注射0.25％罗哌卡因1.5 mg/kg,B组注入等量生理盐水.术后两组患者均给予帕瑞昔布钠40 mg及静脉自控镇痛.观察患者术后2(T1)、6(T2)、12(T3)、24 h(T4)静息时的视觉模拟评分(visual analogue scales,VAS),统计患者24 h内镇痛泵按压次数及患者头晕、恶心、呕吐发生例数. 结果 A组T1～T3时的VAS评分低于B组(P＜0.05).两组T4时的VAS评分比较,差异无统计学意义(P＞0.05).A组术后镇痛泵按压次数(4.9±1.2)次,明显少于B组(8.6±2.2)次(P＜0.05).B组头晕发生率45％、恶心发生率40％、呕吐发生率20％,明显高于A组(P＜0.05).结论 TAP阻滞能改善老年患者腹腔镜腹股沟疝修补术术后疼痛,减少阿片类药物的应用及其副作用.
목적 탐토복횡기평면(transverse abdominis plane,TAP)조체대노년환자복강경복고구산수보술술후진통효과적영향. 방법 선택행복강경복고구산수보술적노년환자40례,안조수궤수자표법분위관찰조(A조)화대조조(B조),매조20례.전신마취유도완성후초성인도하실시환측TAP조체,A조주사0.25％라고잡인1.5 mg/kg,B조주입등량생리염수.술후량조환자균급여파서석포납40 mg급정맥자공진통.관찰환자술후2(T1)、6(T2)、12(T3)、24 h(T4)정식시적시각모의평분(visual analogue scales,VAS),통계환자24 h내진통빙안압차수급환자두훈、악심、구토발생례수. 결과 A조T1～T3시적VAS평분저우B조(P＜0.05).량조T4시적VAS평분비교,차이무통계학의의(P＞0.05).A조술후진통빙안압차수(4.9±1.2)차,명현소우B조(8.6±2.2)차(P＜0.05).B조두훈발생솔45％、악심발생솔40％、구토발생솔20％,명현고우A조(P＜0.05).결론 TAP조체능개선노년환자복강경복고구산수보술술후동통,감소아편류약물적응용급기부작용.
Objective To investigate the effects of transverse abdominis plane(TAP) block on postoperative analgesia in old patients undergoing laparoscopic inguinal hernia repair.Methods Forty consecutive cases of old patients with laparoscopic inguinal hernia repair were randomly divided into observation group (group A) and control group (group B),20 cases in each group.After general anesthesia induction,patients received ultrasound-guided TAP block,with 0.25％ ropivacaine 1.5 mg/kg (group A) or saline (group B).Two groups of patients were given 40 mg parecoxib sodium and patient-controlled intravenous analgesia on postoperative.Observe the rest-visual analogue scales (VAS) score after surgery at 2 (T1),6(T2),12 (T3),24 h (T4) data on the number of patients with nausea and vomiting were collected.Results The VAS score of group A were lower than group B at T1,T2,T3 (P＜0.05).VAS at T4 there were no significant different (P＞0.05).The PCA pressing times of group A was (4.9±1.2),were less than group B (8.6±2.2)(P＜0.05).Compared with group A,the rate of occurrence of symptoms such as dizziness,nausea,vomiting were 45％,40％,20％,were more in group B (P＜0.05).Conclusions TAP block improved postoperative analgesia in old patients undergoing laparoscopic inguinal hernia repair,and also reduced the dose of opioid drugs and for that matter their side effects.