B超引导下不同浓度罗哌卡因腹横肌平面阻滞应用于老年腹腔镜直肠癌根治术术后镇痛效果的观察

郭建桃; 林函; 李梅; 王文伟

doi:10.16766/j.cnki.issn.1674-4152.2017.11.044

B超引导下不同浓度罗哌卡因腹横肌平面阻滞应用于老年腹腔镜直肠癌根治术术后镇痛效果的观察

doi: 10.16766/j.cnki.issn.1674-4152.2017.11.044

郭建桃¹,
林函^2, ,,
李梅¹,
王文伟¹

1. 台州市第一人民医院麻醉科, 浙江台州 318020;
2. 温州医科大学附属第二医院麻醉科, 浙江温州 325027

基金项目:

2012年浙江省医药卫生一般研究计划 (2012KYB-246)

详细信息

通讯作者:
林函,E-mail:nanlinhannansh@qq.com

中图分类号: R614.2;R735.37
计量
- 文章访问数: 80
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- 被引次数: 0
出版历程
- 收稿日期: 2017-04-27
- 网络出版日期: 2022-08-06

The analgesic effect of Ultrasound guided transversus abdominis plane block of ropivacaine with different concentrations in laparoscopic radical rectal cancer in elderly patients after surgery

Department of Anesthesiology, TaiZhou First People's Hospital, TaiZhou, Zhejiang 318020, China

摘要

摘要: 目的观察B超引导下不同浓度罗哌卡因腹横肌平面阻滞应用于腹腔镜直肠癌根治术老年患者术后镇痛效果。方法回顾性分析台州市第一人民医院于2013年1月—2017年1月收治的需行腹腔镜直肠癌根治术老年患者90例临床资料，根据麻醉方式分为3组，3组均于全麻诱导后行B超引导下双侧腹横肌平面阻滞，A、B、C 3组分别注射0.10%、0.25%、0.50%盐酸罗哌卡因25 ml；术后均给予静脉镇痛泵：舒芬太尼0.8 μg/kg+昂丹司琼16 mg+布托啡诺10 mg+生理盐水配置成100 ml，设置背景剂量2 ml/h，锁定时间15 min，Bolus剂量2 ml。观察3组麻醉前(T0)、术后1 h (T1)、术后12 h (T2)、术后24 h (T3)及术后48 h (T4)平均动脉压(MAP)及心率(HR)水平变化；并比较3组术后视觉模拟评分(VAS评分)；记录术后24 h镇痛泵按压次数及舒芬太尼使用总量；比较3组术后不良反应。结果 A组术后1 h、术后12 h、术后24 h MAP及HR均高于B组、C组，且A组T1、T2、T3 MAP及HR均高于T0时刻(均P<0.05)；B组T1时刻MAP及HR均高于C组(P<0.05)，B组血流动力学更为平稳；A组T1、T2、T3、T4时刻VAS评分均低于B组、C组(均P<0.05)，且B组、C组VAS评分比较差异无统计学意义(P>0.05)；A组24 h内镇痛泵按压次数及舒芬太尼总量均高于B组、C组(均P<0.05)；C组不良反应发生率高于A组及B组(P<0.05)。结论 B超引导0.25%罗哌卡因腹横肌平面阻滞应用于腹腔镜直肠癌根治术老年患者术后镇痛效果较佳，且不良反应发生率低。
- B超 /
- 罗哌卡因 /
- 腹横肌平面阻滞 /
- 腹腔镜直肠癌根治术 /
- 老年 /
- 术后镇痛
Abstract: Objective To observe the effect of ultrasound guided transversus abdominis plane block of ropivacaine with different concentrations in laparoscopic radical resection of rectal cancer in elderly patients with postoperative analgesia. Methods The clinical data of 90 elderly patients treated in our hospital from January,2013 to January,2017 which underwent laparoscopic radical resection of rectal cancer were enrolled in the study. According to anesthesia method they were divided into three groups,all in the induction of general anesthesia after ultrasound-guided bilateral transversus abdominis plane block.A,B,C three groups were injected with 0.10%,0.25%,0.50% ropivacaine hydrochloride 25 ml; postoperative intravenous analgesia pump:sufentanil 0.8 g/kg+ondansetron 16 mg+butorphanol 10 mg saline configured for 100 ml,set the background dose of 2 ml/h.Controlled time 15 min,self-control dose 2 ml.The two groups were observed mean arterial pressure(MAP) and heart rate(HR) level changes Before anesthesia(T0),1 h after surgery(T1),12 h after surgery(T2),24 h after surgery(T3)and 48 h(T4) after surgery; visual analogue score were compared between the three groups after operation(VAS score) were recorded after 24 h; The use of sufentanil analgesia pressing times and total; adverse reactions were compared between the three groups. Results Group A MAP and HR at 1 h after surgery(T1),12 h after surgery(T2),24 h after surgery were higher than group B,group C and group A MAP and HR at T1,T2,T3 were higher than that of T0 moment(P<0.05);group B MAP,HR at T1 were higher than that of group C(P<0.05),group B had more stable hemodynamics.Group A VAS scores at T1,T2,T3,T4 time were lower than the group B,group C(P<0.05),and there was no significant difference in VAS score between group C and group B(P>0.05);Group A 24 h analgesia the presses of the pump and the total sufentanil were higher than B group,C group(P<0.05);the incidence of complications in group C was higher than that of group A and group B(P<0.05). Conclusion Ultrasound guided transversus abdominis plane block with 0.25% ropivacaine used in laparoscopic radical resection of rectal cancer patients with postoperative analgesia in the elderly is better,and the incidence of adverse reactions is low.
- Ultrasound /
- Ropivacaine /
- Transversus abdominis plane block /
- Laparoscopic radical resection of rectal cancer /
- Elderly /
- Postoperative analgesia