| .无阿片类药物全麻复合双侧TAPB应用于妇科腹腔镜手术中的
随机对照研究[J].,2024,(24):4730-4732 |
| 无阿片类药物全麻复合双侧TAPB应用于妇科腹腔镜手术中的
随机对照研究 |
| Randomized Controlled Study of Opioid-Free General AnesthesiaCombined with Bilateral TAPB in Gynecological Laparoscopic Surgery |
| 投稿时间：2024-08-21 修订日期：2024-09-16 |
| DOI：10.13241/j.cnki.pmb.2024.24.030 |
| 中文关键词: 无阿片类药物 腹横肌平面阻滞 全身麻醉 妇科腹腔镜手术 |
| 英文关键词: Opioid-free Transversus abdominis plane block General anesthesia Gynecological laparoscopic surgery |
| 基金项目:东莞市社会科技发展面上项目（20211800900192）；广东省自然科学基金项目（2019A1515011636） |
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| 中文摘要: |
| 摘要 目的：观察无阿片类药物全麻复合双侧腹横肌平面阻滞（TAPB）应用于妇科腹腔镜手术中的效果。方法：采用随机数字表法将126例需行妇科腹腔镜手术治疗的患者分为单一组（接受全凭静脉全身麻醉，n=63）和联合组（接受无阿片类药物全麻复合双侧TAPB，n=63）。观察两组术后疼痛、镇静情况、麻醉术后恢复时间、抑郁、睡眠改善情况和术后恶心呕吐发生情况、止吐药物应用情况。结果：术后12 h、24 h，两组视觉模拟评分法（VAS）评分升高，Ramsay镇静评分下降（P＜0.05），且联合组VAS评分低于单一组同期，Ramsay镇静评分高于单一组同期（P＜0.05）。联合组自主呼吸恢复时间、苏醒时间、气管插管拔除时间短于单一组（P＜0.05）。术后7 d、14 d，两组汉密尔顿抑郁量表-17（HAMD-17）、匹兹堡睡眠质量指数（PSQI）评分下降（P＜0.05），且联合组HAMD-17、PSQI评分低于单一组同期（P＜0.05）。联合组术后恶心呕吐发生情况、止吐药物应用情况低于单一组（P＜0.05）。结论：无阿片类药物全麻复合双侧TAPB在妇科腹腔镜手术中效果较好，可显著镇静、镇痛，促进术后恢复，改善患者术后抑郁情况和睡眠质量，且安全性较好。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of opioid-free general anesthesia combined with bilateral transversus abdominis plane block (TAPB) in gynecological laparoscopic surgery. Methods: 126 patients who needed gynecological laparoscopic surgery were divided into single group (receiving total intravenous general anesthesia, n=63) and combined group (receiving opioid-free general anesthesia combined with bilateral TAPB, n=63) by using random number table method. The postoperative pain, sedation, recovery time after anesthesia, depression, sleep improvement, postoperative nausea and vomiting, and application of antiemetic drugs were observed in two groups. Results: 12 h and 24 h after operation, the visual analogue scale (VAS) scores in two groups increased, and the Ramsay sedation score decreased (P<0.05). The VAS score in combined group was lower than that in single group at the same time, and the Ramsay sedation score was higher than that in single group at the same time (P<0.05). The spontaneous breathing recovery time, recovery time and tracheal intubation removal time in combined group were shorter than those in single group (P<0.05). 7 d and 14 d after operation, the scores of Hamilton Depression Scale-17 (HAMD-17) and Pittsburgh Sleep Quality Index (PSQI) in two groups decreased (P<0.05), and the scores of HAMD-17 and PSQI in combined group were lower than those in single group at the same time (P<0.05). The incidence of postoperative nausea and vomiting and the application of antiemetic drugs in combined group were lower than those in single group (P<0.05). Conclusion: Opioid-free general anesthesia combined with bilateral TAPB has a good effect in gynecological laparoscopic surgery, which can significantly calm and relieve pain, promote postoperative recovery, improve postoperative depression and sleep quality, and has good safety. |
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