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超声引导下腹横肌平面阻滞和Trocar局部浸润在腔镜下子宫切除术后镇痛效应的对照性研究

, PP. 1889-1891

Keywords: 腹腔镜子宫消除,局麻药,镇痛

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Abstract:

目的比较超声引导下的腹横肌平面(transversusabdominisplane,TAP)阻滞和Trocar局部浸润两种镇痛模式用于腹腔镜下子宫切除术的术后镇痛效果。方法选择2014年5至11月在兰州大学第二医院妇科行腹腔镜下子宫切除术的71例子宫良性病变患者为研究对象,分为TAP阻滞组(B组)和局部浸润组(Ⅰ组):B组35例,年龄(43.11±4.33)岁,在全麻气管插管后实施双侧超声引导下的腹横肌阻滞;Ⅰ组36例,年龄(42.28±4.10)岁,手术结束后行Trocar插入局域局麻药浸润。观察术后即刻及1、2、4、8、12、24h数字疼痛强度量表(numericratingscore,NRS)评分,并分别记录额外需要的镇痛药和相关的不良反应。结果B组患者在术后各观察时点的NRS均明显的低于I组患者(P<0.05);B组患者术后帕瑞西布钠用量明显低于Ⅰ组(P<0.05);两组患者舒芬太尼的应用例数大致相等(P>0.05)。另外,不良反应的发生率在两组间没有统计学差异(P>0.05)。结论超声引导下的腹横肌平面阻滞相比Trocar局部药浸润,能更为有效地缓解行腔镜下子宫切除术患者的术后疼痛,明显减少其他镇痛药物的应用。

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