无阿片类药物全麻复合双侧TAPB应用于妇科腹腔镜手术中的随机对照研究
Randomized Controlled Study of Opioid-Free General Anesthesia Combined with Bilateral TAPB in Gynecological Laparoscopic Surgery
陈杰 1冯淑燕 1管小明 1陈传义 1宫喜双2
作者信息
- 1. 广州中医药大学东莞医院麻醉科 广东东莞 523000
- 2. 广州中医药大学东莞医院妇产科 广东东莞 523000
- 折叠
摘要
目的:观察无阿片类药物全麻复合双侧腹横肌平面阻滞(TAPB)应用于妇科腹腔镜手术中的效果.方法:采用随机数字表法将126例需行妇科腹腔镜手术治疗的患者分为单一组(接受全凭静脉全身麻醉,n=63)和联合组(接受无阿片类药物全麻复合双侧TAPB,n=63).观察两组术后疼痛、镇静情况、麻醉术后恢复时间、抑郁、睡眠改善情况和术后恶心呕吐发生情况、止吐药物应用情况.结果:术后12h、24h,两组视觉模拟评分法(VAS)评分升高,Ramsay镇静评分下降(P＜0.05),且联合组VAS评分低于单一组同期,Ramsay镇静评分高于单一组同期(P＜0.05).联合组自主呼吸恢复时间、苏醒时间、气管插管拔除时间短于单一组(P＜0.05).术后7d、14d,两组汉密尔顿抑郁量表-17(HAMD-17)、匹兹堡睡眠质量指数(PSQI)评分下降(P＜0.05),且联合组HAMD-17、PSQI评分低于单一组同期(P＜0.05).联合组术后恶心呕吐发生情况、止吐药物应用情况低于单一组(P＜0.05).结论:无阿片类药物全麻复合双侧TAPB在妇科腹腔镜手术中效果较好,可显著镇静、镇痛,促进术后恢复,改善患者术后抑郁情况和睡眠质量,且安全性较好.
Abstract
Objective:To observe the effect of opioid-free general anesthesia combined with bilateral transversus abdominis plane block(TAPB)in gynecological laparoscopic surgery.Methods:126 patients who needed gynecological laparoscopic surgery were divid-ed into single group(receiving total intravenous general anesthesia,n=63)and combined group(receiving opioid-free general anesthesia combined with bilateral TAPB,n=63)by using random number table method.The postoperative pain,sedation,recovery time after anes-thesia,depression,sleep improvement,postoperative nausea and vomiting,and application of antiemetic drugs were observed in two groups.Results:12 h and 24 h after operation,the visual analogue scale(VAS)scores in two groups increased,and the Ramsay sedation score decreased(P＜0.05).The VAS score in combined group was lower than that in single group at the same time,and the Ramsay seda-tion score was higher than that in single group at the same time(P＜0.05).The spontaneous breathing recovery time,recovery time and tracheal intubation removal time in combined group were shorter than those in single group(P＜0.05).7 d and 14 d after operation,the scores of Hamilton Depression Scale-17(HAMD-17)and Pittsburgh Sleep Quality Index(PSQI)in two groups decreased(P＜0.05),and the scores of HAMD-17 and PSQI in combined group were lower than those in single group at the same time(P＜0.05).The incidence of postoperative nausea and vomiting and the application of antiemetic drugs in combined group were lower than those in single group(P＜0.05).Conclusion:Opioid-free general anesthesia combined with bilateral TAPB has a good effect in gynecological laparoscopic surgery,which can significantly calm and relieve pain,promote postoperative recovery,improve postoperative depression and sleep qual-ity,and has good safety.
关键词
无阿片类药物/腹横肌平面阻滞/全身麻醉/妇科腹腔镜手术Key words
Opioid-free/Transversus abdominis plane block/General anesthesia/Gynecological laparoscopic surgery引用本文复制引用
出版年
2024
NETL
NSTL
万方数据