腹横肌平面阻滞用于切口疝修补术后镇痛效果分析
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南京大学医学院附属鼓楼医院

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国家自然科学基金(81600958);南京市卫生科技发展专项资金项目(YKK22089);2022年度南京鼓楼医院临床研究专项资金(No.2022-LCYJ-PY-37)


Effect of transversal plane block on postoperative pain in incisional hernia repair surgery
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National Natural Science Foundation of China (No. 81600958);Nanjing Health Science and Technology Development Special Fund Project(YKK22089);Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University(No.2022-LCYJ-PY-37)

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    摘要:

    目的:探讨超声引导腹横肌平面阻滞(transversus abdominis plane block, TAPB)对下腹部切口疝修补术术后疼痛影响。方法:选择择期全身麻醉行腹部切口疝无张力修补术患者60例,采用随机法分为C组(对照组)和TAPB组,每组30例。C组行常规全麻;TAPB组全麻后行超声引导下腹横肌平面阻滞。以视觉模拟评分法(visual analogue scale,VAS)评估术后2h,4h,6h,24h,90d疼痛评分;记录术前、术中、术后患者的平均动脉压(mean arterial pressure,MAP)和心率(heart rate,HR)的变化,术中芬太尼和瑞芬太尼的使用量,术后恶心呕吐的发生率,抽血检测术前和术后24h血清皮质醇(cortisol,Cor)、去甲肾上腺素(norepinephrine,NE)、白介素6(interleukin-6,IL-6)水平。结果:TAPB组患者术后2h、6h、24h、90d的VAS评分,术中、术后MAP,术中芬太尼使用量及术后24h血清Cor、NE、IL-6水平均显著低于C组(P<0.05)。结论:腹横肌平面阻滞可为下腹部切口疝修补术患者提供良好的术后镇痛,减轻炎症和应激反应。

    Abstract:

    Objective: To investigate the effect of ultrasound-guided transversus abdominis plane block (TAPB) on postoperative pain after lower abdominal incisional hernia repair. Methods:Sixty patients, undergoing elective tension-free repair of abdominal incisional hernia, were randomly divided into C group (control group, n=30) and TAPB group (n = 30). The control group received routine general anesthesia, while the TAPB group were given ultrasound-guided transversus abdominis plane block after general anesthesia. The scores of visual analogue scales (VAS) at 2h, 4h, 6h, 24h and 90d after operation, the mean arterial pressure (MAP) and heart rate (HR) before, during and after operation, the intraoperative consumption of fentanyl and remifentanil, the incidence of postoperative nausea and vomiting, and the levels of serum cortisol (Cor), norepinephrine (NE), and interleukin-6 (IL-6) before and 24h after operation were compared between the two groups. Results: Compared with Group C, the VAS scores at postoperative 2 h, 6 h, 24h and 90d, the intraoperative and postoperative MAP, the intraoperative fentanyl consumption, and the levels of Cor, NE and IL-6 at postoperative 24h were significantly lower in TAPB group( P < 0.05). Conclusion: Transversus abdominis plane block can improve patients postoperative analgesia and also reduce inflammation and stress response after abdominal incisional hernia repair.

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  • 收稿日期:2023-03-24
  • 最后修改日期:2023-09-19
  • 录用日期:2023-10-25
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