CAJ | 학술논문

目的探讨超声引导腹横肌平面(TAP)阻滞对卵巢癌根治术中七氟醚浓度的影响.方法全麻下行卵巢癌根治术患者随机、单盲法分为术前TAP阻滞组(T组)和对照组(C组).记录麻醉诱导前、切皮前2 min至切皮后5 min中每分钟的心率、平均动脉压及七氟醚浓度.采用改良上下交叉点法计算得出每组的抑制肾上腺素能反应呼气末肺泡内最低有效浓度(MACBAR).同时观察患者拔管时间及苏醒期躁动情况,并做评分记录.结果 2组患者年龄、身高、体质量、麻醉诱导前基础心率及平均动脉压比较无明显差别(P>0.05).C组平均七氟醚MACBAR为(4.16±0.42)%,T组为(1.96±0.37)%,2组比较有显著差别(P<0.05).平均拔管时间为C组(7.2±1.5)min,T组(3.5±1.1)min,具有统计学差异(P<0.05).C组患者术后发生躁动12/20,T组3/20,2组有显著差异(P<0.05).结论超声引导腹横肌平面阻滞在妇科卵巢癌根治术中能够有效镇痛,降低七氟醚用量,缩短术后苏醒时间、减少术后躁动的发生.
목적 탐토초성인도복횡기평면(TAP)조체대란소암근치술중칠불미농도적영향.방법 전마하행란소암근치술환자수궤、단맹법분위술전TAP조체조(T조)화대조조(C조).기록마취유도전、절피전2 min지절피후5 min중매분종적심솔、평균동맥압급칠불미농도.채용개량상하교차점법계산득출매조적억제신상선소능반응호기말폐포내최저유효농도(MACBAR).동시관찰환자발관시간급소성기조동정황,병주평분기록.결과 2조환자년령、신고、체질량、마취유도전기출심솔급평균동맥압비교무명현차별(P>0.05).C조평균칠불미MACBAR위(4.16±0.42)%,T조위(1.96±0.37)%,2조비교유현저차별(P<0.05).평균발관시간위C조(7.2±1.5)min,T조(3.5±1.1)min,구유통계학차이(P<0.05).C조환자술후발생조동12/20,T조3/20,2조유현저차이(P<0.05).결론 초성인도복횡기평면조체재부과란소암근치술중능구유효진통,강저칠불미용량,축단술후소성시간、감소술후조동적발생.
Objective To investigate the influence of ultrasonic?guided transversus abdominis plane block on the concentration of sevoflurane dur?ing ovarian cancer radical surgery. Methods A randomized,single blinded study was performed. Forty patients undergoing ovarian cancer radical surgery were divided into TAP block group(group T)and control group(group C). Mean arterial blood pressure(MAP)and heart rate(HR)were recorded at baseline and every minute from 2 min before skin incision to 5 min after it. According to the concentration of sevoflurane at the equilibri?um point,the stable end?tidal sevoflurane in each group was calculated(MACBAR)using the up?down method. Results There were no significant differences of the patients'age,body weight,height,HR and MAP before induction of anesthesia and incision between the two groups(P>0.05). Average sevoflurane MACBAR of Group C and group T were 4.16±0.42%and 1.96 ± 0.37%respectively,which have significant differences(P<0.05). The average extubation time of group T was 3.5 ± 1.1min,which was significantly shorter than group C(7.2 ± 1.5 min,P<0.05). There was significant difference of the postoperative agitation between group C(12/20 cases)and T group(3/20 cases),(P<0.05). Conclusion Ultrasound?guided TAP block in ovarian cancer radical surgery not only showed effectively analgesia,but also had a frugal effect on the sevoflurane concentra?tion. In addition,it played a positive role in shorten the recovery time after surgery,which significantly reduced the postoperative agitation.