超声引导腹横肌平面阻滞在卵巢癌根治术中对七氟醚MACBAR的影响

发布时间：2018-07-29 20:45

【摘要】：目的探讨超声引导腹横肌平面(TAP)阻滞对卵巢癌根治术中七氟醚浓度的影响。方法全麻下行卵巢癌根治术患者随机、单盲法分为术前TAP阻滞组(T组)和对照组(C组)。记录麻醉诱导前、切皮前2 min至切皮后5 min中每分钟的心率、平均动脉压及七氟醚浓度。采用改良上下交叉点法计算得出每组的抑制肾上腺素能反应呼气末肺泡内最低有效浓度(MACBAR)。同时观察患者拔管时间及苏醒期躁动情况,并做评分记录。结果 2组患者年龄、身高、体质量、麻醉诱导前基础心率及平均动脉压比较无明显差别(P0.05)。C组平均七氟醚MACBAR为(4.16±0.42)%,T组为(1.96±0.37)%,2组比较有显著差别(P0.05)。平均拔管时间为C组(7.2±1.5)min,T组(3.5±1.1)min,具有统计学差异(P0.05)。C组患者术后发生躁动12/20,T组3/20,2组有显著差异(P0.05)。结论超声引导腹横肌平面阻滞在妇科卵巢癌根治术中能够有效镇痛,降低七氟醚用量,缩短术后苏醒时间、减少术后躁动的发生。
[Abstract]:Objective to investigate the effect of ultrasound guided abdominal transverse muscle level (TAP) block on sevoflurane concentration in radical resection of ovarian cancer. Methods patients undergoing radical ovarian cancer surgery under general anesthesia were randomly divided into preoperative TAP block group (T group) and control group (C group). Heart rate, mean arterial pressure and sevoflurane concentration were recorded at 2 min before anesthesia induction and 5 min after incision. The lowest effective concentration of (MACBAR). In the end of expiratory alveolar response was calculated by using the improved method of intersecting the upper and lower intersections of each group in order to inhibit adrenergic response. At the same time, the time of extubation and restlessness during recovery were observed, and the score was recorded. Results there was no significant difference in age, height, body weight, basal heart rate and mean arterial pressure between the two groups (P0.05). The average MACBAR of sevoflurane in group C was (4.16 卤0.42) vs (1.96 卤0.37) in group T (P0.05). The mean extubation time was (7.2 卤1.5) min in group C (3.5 卤1.1 min), with statistical difference (P0.05). Conclusion Ultrasound-guided abdominal transverse muscle block can effectively analgesia, reduce the dosage of sevoflurane, shorten the recovery time and reduce postoperative restlessness in gynecologic ovarian cancer.
【作者单位】：中国医科大学附属第一医院麻醉科;
【基金】：辽宁省博士科研启动项目(20141035)
【分类号】：R614.1;R737.31

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