超声引导下腹横肌平面阻滞联合喉罩全麻在老年患者下腹部手术中的应用

发布时间：2018-05-15 20:42

本文选题：腹横肌平面阻滞 + 喉罩　；参考：《临床麻醉学杂志》2015年08期

【摘要】：目的观察超声引导下腹横肌平面阻滞(transversus abdominis plane block,TAPB)联合喉罩全麻在老年患者下腹部手术中的临床效果。方法拟行腹股沟疝修补术或阑尾切除术老年患者40例,年龄65岁,随机数字表法均分为TAPB组(T组)和对照组(C组)。麻醉诱导后置入Supreme喉罩,在超声引导下行手术侧TAPB,分别注入0.375%罗哌卡因15ml(T组)或等容量生理盐水(C组)。记录麻醉药用量、苏醒时间和拔喉罩时间,以及术后2h(T1)、6h(T2)、12h(T3)、24h(T4)、48h(T5)的静态和动态VAS疼痛评分。记录不良反应发生情况。结果与C组比较,T组丙泊酚、瑞芬太尼用量明显减少,苏醒时间、拔喉罩时间明显缩短(P0.05);T1~T4时静态和T1~T5时动态VAS疼痛评分明显降低(P0.05)。两组患者术后不良反应差异无统计学意义。结论与单纯静脉全麻相比,TAPB联合喉罩全麻用于老年患者下腹部手术可减少麻醉药用量,缩短恢复时间,不增加不良反应。
[Abstract]:Objective to observe the clinical effect of transversus abdominis plane block combined with laryngeal mask general anesthesia guided by ultrasound in lower abdominal surgery in elderly patients. Methods 40 elderly patients aged 65 years with inguinal hernia repair or appendectomy were randomly divided into TAPB group (T group) and control group (C group). After anesthesia induction, Supreme larynx mask was placed, and the operation side was injected with 0.375% ropivacaine 15ml(T group or the same volume normal saline group C under ultrasound guidance. The dose of anesthetic, recovery time and laryngeal mask time were recorded, and the static and dynamic VAS pain scores were recorded 2 hours after operation. Adverse reactions were recorded. Results compared with group C, the dosage of propofol and remifentanil in group C was significantly reduced, the recovery time and laryngeal mask time were significantly shortened at static and dynamic VAS pain scores of P0.05 and T1T4 at T1~T5. There was no significant difference in postoperative adverse reactions between the two groups. Conclusion compared with simple intravenous general anesthesia, TAPB combined with laryngeal mask general anesthesia can reduce the dosage of anesthetics, shorten the recovery time, and do not increase adverse reactions in elderly patients with lower abdominal surgery.
【作者单位】：南京中医药大学附属中西医结合医院江苏省中西医结合医院麻醉科;
【分类号】：R614

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