腹横肌平面阻滞对局部麻醉下腹股沟疝修补术的疗效分析

发布时间：2018-03-13 23:36

本文选题：神经传导阻滞　切入点：腹肌　出处：《中国现代医学杂志》2015年20期 　论文类型：期刊论文

【摘要】：目的评价腹横肌平面(TAP)阻滞对局部麻醉下腹股沟疝修补术患者的临床疗效。方法选取择期在局部麻醉下行腹股沟疝修补术患者60例,年龄58~82岁,采用随机数字表法,将患者分为两组,生理盐水对照组(A组)和TAP阻滞组(B组),每组30例。A组注入等容量生理盐水20 ml,B组注入0.375%罗哌卡因20 ml,阻滞成功后开始常规手术区消毒、铺巾,局部麻醉并手术。比较两组患者切皮反应、术中心率变化、VAS评分、术后VAS评分及镇痛总体满意度评分,记录TAP阻滞相关不良反应的发生。结果 B组无患者补救镇痛。B组术中心率、血压平稳,术中、术后VAS评分降低,镇痛总体满意度评分与A组比较有提高,差异有统计学意义(P0.05)。B组未发生TAP阻滞相关不良反应。结论 TAP阻滞对局部麻醉下腹股沟疝修补术患者的疗效满意,安全性较高,并能有效阻滞术中迷走神经反射。其改进的麻醉技术有利于在日间手术室开展腹股沟疝修补术。
[Abstract]:Objective to evaluate the clinical effect of TAP block on inguinal herniorrhaphy under local anesthesia. Methods 60 patients, aged 58 to 82 years, underwent selective inguinal hernia repair under local anesthesia. The patients were divided into two groups: normal saline control group (group A) and TAP block group (group B: 30 cases in each group). Group B was injected with 0.375% ropivacaine 20 ml in equal volume. After the block was successful, the routine operation area was disinfected and the towel was spread. Local anaesthesia combined with operation. The skin incision reaction, heart rate change during operation, postoperative VAS score and total satisfaction score of analgesia were compared between the two groups. Results the heart rate, blood pressure, VAS score were decreased in group B. the total satisfaction score of analgesia was higher than that in group A. There were no adverse reactions associated with TAP block in group P0.05.B.Conclusion TAP block is effective and safe in patients with inguinal hernia repair under local anesthesia. It can block vagus reflex effectively. The improved anaesthesia technique is helpful to repair inguinal hernia in daytime operating room.
【作者单位】：天津港口医院外科;
【分类号】：R656.21

【参考文献】