腹横肌平面阻滞对老年患者胃癌根治术后全麻苏醒期躁动的影响

发布时间：2018-03-31 19:39

本文选题：胃肿瘤　切入点：超声检查　出处：《福建医科大学学报》2017年03期

【摘要】：目的探讨腹横肌平面(TAP)阻滞对老年患者胃癌根治术后全麻苏醒期躁动的影响。方法选择择期经腹胃癌根治术老年患者60例,随机分为2组:即腹横肌平面阻滞组(TAP组)和对照组(N组)。所有患者均于麻醉诱导插管后行超声引导下双侧肋缘下TAP阻滞,TAP组给予0.5%盐酸罗哌卡因单侧20 mL,双侧共40mL;N组给予等量生理盐水。于麻醉诱导前(T_0)、拔除气管导管时(T_1)、出麻醉后恢复室时(T_2)、术后8h(T_3)、术后24h(T_4)和术后48h(T_5),记录平均动脉压(MAP)、心率(HR)、Prince-Henry疼痛(PH)评分、Riker镇静躁动评分(SAS)、术后第1次下床时间和术后住院时间。结果 TAP组疼痛评分、躁动发生率显著低于N组(P0.05);与N组比较,TAP组T_(2~5)时MAP和HR显著降低(P0.05),术后第1次下床时间显著缩短(P0.05);2组患者的术后住院时间比较,差别无统计学意义(P0.05)。结论 TAP阻滞可减少老年患者经腹胃癌根治术后全麻苏醒期躁动的发生率,使血流动力学更稳定,有利于术后早期下床活动。
[Abstract]:Objective to investigate the effect of TAP block on restlessness after general anesthesia in elderly patients with gastric cancer. Two groups were randomly divided into two groups: the abdominal transverse muscle block group (TAP group) and the control group (n group). All the patients were given unilateral 20 mL ropivacaine hydrochloride and bilateral bilateral ropivacaine 0.5% ropivacaine under the guidance of ultrasound guided bilateral intercostal block tap after anesthesia induction and intubation. Group N was given the same amount of normal saline before anesthesia induction. Before induction of anesthesia, T _ (0), T _ (1), T _ (2), T _ (2) and T _ (3) at 8 h after anesthesia, and T _ (5) at 48 h after operation were recorded, and mean arterial pressure (MAPP), heart rate (HRR) (Princess Henry pain) score (Riker sedative restlessness score) and restlessness score (SASN) were recorded. Results the time of getting out of bed and the time of hospitalization after operation. Results the pain score of TAP group, The incidence of restlessness was significantly lower in group N than that in group N (P 0.05), and the MAP and HR in group C were significantly lower than those in group N (P 0.05), and the time of getting out of bed at the first time after operation was significantly shorter than that in group N, and the postoperative hospitalization time of group 2 was significantly shorter than that of group C (P 0.05), and the incidence of restlessness was significantly lower than that in group N (P 0.05). Conclusion TAP block can reduce the incidence of restlessness in the old patients after radical operation of gastric cancer under general anesthesia, make the hemodynamics more stable, and benefit to get out of bed early after operation.
【作者单位】：福建医科大学附属第一医院麻醉科;厦门大学附属第一医院麻醉科;
【基金】：福建医科大学启航基金项目(2016QH048)
【分类号】：R614.2;R735.2

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