CAJ | 학술논문

目的：比较腹横肌平面阻滞联合静脉镇痛或硬膜外镇痛对开放性胃肠道肿瘤切除术后疼痛和早期康复的影响。方法100例择期行开放性胃肠道肿瘤切除术的患者随机分为2组,一组术前做单次腹横肌平面阻滞联合术后静脉镇痛(T组),另一组术后行硬膜外镇痛(E组),比较2组术后2、24、48、72h的静息和咳嗽时疼痛的视觉模拟评分(VAS评分)以及肠功能、自主排尿功能等早期康复指标。结果与T组相比,E组术后2、24、48、72h的安静和咳嗽时的VAS评分均显著降低,术后肛门恢复排气所需时间明显减少。结论胃肠道肿瘤切除术后使用硬膜外镇痛较腹横肌平面阻滞联合静脉镇痛提供更好的镇痛效果并有利于肠功能恢复。
목적：비교복횡기평면조체연합정맥진통혹경막외진통대개방성위장도종류절제술후동통화조기강복적영향。방법100례택기행개방성위장도종류절제술적환자수궤분위2조,일조술전주단차복횡기평면조체연합술후정맥진통(T조),령일조술후행경막외진통(E조),비교2조술후2、24、48、72h적정식화해수시동통적시각모의평분(VAS평분)이급장공능、자주배뇨공능등조기강복지표。결과여T조상비,E조술후2、24、48、72h적안정화해수시적VAS평분균현저강저,술후항문회복배기소수시간명현감소。결론위장도종류절제술후사용경막외진통교복횡기평면조체연합정맥진통제공경호적진통효과병유리우장공능회복。
Objective To compare the postoperative analgesic efficacy and the bowel function recovery of the combination of transversus abdominis plane block and intravenous analgesia or epidural analgesia for patients underwent gastrointestinal cancer surgeries. Method 100 patients undergoing open resections of gastrointestinal cancer were randomly allocated into transverses ab-dominis plane block combined with intravenous analgesia group( Group T) or epidural analgesia( Group E) . The primary outcome was visual analog scales postoperative pain intensity at rest and on coughing. The secondary outcomes were the return of bowl func-tion and other parameters related to postoperative recovery including length of postoperative hospital stay et al. Results Compared with the Group T, group E showed lower pain scores both at rest and on coughing after the operation(P<0. 001)and earlier return of bowl function. Conclusion Postoperative epidural analgesia achieved better pain control and earlier return of bowl functions than the combination of transversus abdominis plane block and intravenous analgesia for gastrointestinal cancer resections.