超声引导下腹横肌平面阻滞对腹腔镜胆囊切除术中麻醉深度和阻滞效果的影响(1)
[摘要]目的 探討超声引导下腹横肌平面阻滞(TAPB)对腹腔镜胆囊切除术中麻醉深度和不同穿刺切口阻滞效果的影响。方法 选取2017年1月～2018年2月东莞市第五人民医院收治的82例腹腔镜胆囊切除术患者作为研究对象，随机分为对照组和研究组，每组各41例。对照组应用喉罩全身麻醉，研究组应用超声引导下TAPB复合喉罩全身麻醉。统计并比较两组患者的脐部U、剑突下X、右肋缘下C 3个穿刺切口的视觉模拟量表(VAS)评分、麻醉恢复情况、并发症总发生率，麻醉前后两组患者的血压和心率。结果 研究组有2例退出研究，中转开腹1例，手术时间超过180 min 1例；对照组中退出研究1例，为中转开腹。研究组患者的脐部、剑突下、右肋缘下VAS评分均低于对照组，差异有统计学意义(P<0.05)；研究组患者脐部VAS评分显著低于剑突下和右肋缘下，差异有统计学意义(P<0.05)；研究组患者的拔管时间、睁眼时间和自主呼吸时间均显著短于对照组，差异有统计学意义(P<0.05)；研究组患者的并发症总发生率为15.38%，显著低于对照组的37.50%，差异有统计学意义(P<0.05)；研究组患者麻醉后的收缩压、舒张压及心率显著低于对照组，差异有统计学意义(P<0.05)。结论 腹腔镜胆囊切除术的麻醉过程中，超声引导下TAPB的麻醉效果较好，应该在临床上大力推广应用。
[关键词]超声；腹横肌平面阻滞；腹腔镜胆囊切除术；阻滞
[中图分类号] R575.6 [文献标识码] A [文章编号] 1674-4721(2019)5(c)-0113-04
Effect of ultrasound-guided transversus abdominis plane block on anesthesia depth and blocking effect in laparoscopic cholecystectomy
YANG Xiao-li1 CHEN Li2 TAN Wan-yi1 QIU Xun-bin1
1. Department of Anesthesiology， Dongguan Fifth People′s Hospital， Guangdong Province， Dongguan 523900， China； 2. Department of Gynecology and Obstetrics， Dongguan Humen People′s Hospital， Guangdong Province， Dongguan 523900， China
[Abstract] Objective To investigate the effect of ultrasound-guided transversus abdominis plane block (TAPB) on anesthesia depth and puncture incision block in laparoscopic cholecystectomy. Methods Eighty-two patients with laparoscopic cholecystectomy admitted to Dongguan Fifth People′s Hospital from January 2017 to February 2018 were selected as the research subjects and randomly divided into control group and study group， 41 cases in each group. The control group received laryngeal mask general anesthesia， while the study group received ultrasound-guided TAPB combined with laryngeal mask general anesthesia. The visual analogue scale (VAS) scores， anesthesia recovery， total incidence of complications， blood pressure and heart rate before and after anesthesia were compared between the two groups. Results In the study group， 2 cases dropped out of the study， 1 case was converted to laparotomy， and 1 case was operated for more than 180 minutes. In the control group， 1 case dropped out of the study and was converted to laparotomy. The VAS scores of umbilical cord， inferior xiphoid process and inferior right costal margin in the study group were lower than those in the control group， the differences were significant (P<0.05). The umbilical VAS score in the study group was significantly lower than that in the subxiphoid and right costal margins， the differences were significant (P<0.05). The extubation time， eye opening time and spontaneous breathing time of the study group were significantly shorter than those of the control group， the differences were significant (P<0.05). The total incidence of complications in the study group was 15.38%， which was significantly lower than 37.50% in the control group， the difference was significant (P<0.05). The systolic blood pressure， diastolic blood pressure and heart rate after anesthesia in the study group were significantly lower than those in the control group， the differences were significant (P<0.05). Conclusion During the anesthesia process of laparoscopic cholecystectomy， ultrasound-guided TAPB has a good anesthetic effect and should be widely used in clinic., 百拇医药(杨小立 陈莉 谭婉仪)
[关键词]超声；腹横肌平面阻滞；腹腔镜胆囊切除术；阻滞
[中图分类号] R575.6 [文献标识码] A [文章编号] 1674-4721(2019)5(c)-0113-04
Effect of ultrasound-guided transversus abdominis plane block on anesthesia depth and blocking effect in laparoscopic cholecystectomy
YANG Xiao-li1 CHEN Li2 TAN Wan-yi1 QIU Xun-bin1
1. Department of Anesthesiology， Dongguan Fifth People′s Hospital， Guangdong Province， Dongguan 523900， China； 2. Department of Gynecology and Obstetrics， Dongguan Humen People′s Hospital， Guangdong Province， Dongguan 523900， China
[Abstract] Objective To investigate the effect of ultrasound-guided transversus abdominis plane block (TAPB) on anesthesia depth and puncture incision block in laparoscopic cholecystectomy. Methods Eighty-two patients with laparoscopic cholecystectomy admitted to Dongguan Fifth People′s Hospital from January 2017 to February 2018 were selected as the research subjects and randomly divided into control group and study group， 41 cases in each group. The control group received laryngeal mask general anesthesia， while the study group received ultrasound-guided TAPB combined with laryngeal mask general anesthesia. The visual analogue scale (VAS) scores， anesthesia recovery， total incidence of complications， blood pressure and heart rate before and after anesthesia were compared between the two groups. Results In the study group， 2 cases dropped out of the study， 1 case was converted to laparotomy， and 1 case was operated for more than 180 minutes. In the control group， 1 case dropped out of the study and was converted to laparotomy. The VAS scores of umbilical cord， inferior xiphoid process and inferior right costal margin in the study group were lower than those in the control group， the differences were significant (P<0.05). The umbilical VAS score in the study group was significantly lower than that in the subxiphoid and right costal margins， the differences were significant (P<0.05). The extubation time， eye opening time and spontaneous breathing time of the study group were significantly shorter than those of the control group， the differences were significant (P<0.05). The total incidence of complications in the study group was 15.38%， which was significantly lower than 37.50% in the control group， the difference was significant (P<0.05). The systolic blood pressure， diastolic blood pressure and heart rate after anesthesia in the study group were significantly lower than those in the control group， the differences were significant (P<0.05). Conclusion During the anesthesia process of laparoscopic cholecystectomy， ultrasound-guided TAPB has a good anesthetic effect and should be widely used in clinic., 百拇医药(杨小立 陈莉 谭婉仪)