摘要
目的 探讨全麻联合超声引导下腹横筋膜阻滞在腹腔镜子宫切除围术期应用效果.方法 选取2022年3月～2023年3月于我院行腹腔镜下子宫全切的120例患者,随机分为实验组及对照组,各60例.两组患者均采取静吸复合全身麻醉,实验组在超声引导下行腹横筋膜阻滞,局部注射罗哌卡因,对照组在同样位置注射等量生理盐水.记录两组患者术中使用丙泊酚总量、瑞芬太尼的总量、手术时长及术中失血量;记录苏醒后0.5h、1h、6h视觉模拟(VSA)评分;记录术后6h内恶心、呕吐、寒战、腹账不良反应情况.结果 两组患者术中丙泊酚总量、瑞芬太尼总量差异有统计学意义(P＜0.05);两组患者手术时长和术中失血量无明显差异(P＞0.05);苏醒后各个时间点VSA评分差异有统计学意义(P＜0.05);两组患者术后6h内恶心、呕吐、寒战、腹胀的不良反应差异有统计学意义(P＜0.05).结论 超声引导下腹横筋膜阻滞在腹腔镜子宫切除术中可减少麻醉药物用量、术后疼痛轻、不良反应少,患者舒适度高.
Abstract
Objective To explore the application effect of general anesthesia combined with ultrasound-guided transverse fascia block in the perioperative period of laparoscopic hysterectomy.Methods One hundred and twenty patients who underwent laparoscopic total hysterectomy in our hospital from March 2022 to March 2023 were randomly divided into an experimental group and a control group,with 60 cases in each group.Both groups of patients were treated with intravenous inhalation combined with general anesthesia.The experimental group received ultrasound-guided transverse fascia block and local injection of ropivacaine,while the control group received injection of physi-ological saline at the same location.Record the total amount of propofol used during surgery,the total amount of remifentanil used,the duration of surgery,and the amount of intraoperative blood loss in two groups of patients;Record visual analogue(VSA)scores at 0.5,1,and 6 hours after awakening;Record adverse reactions such as nausea,vomiting,chills,and abdominal distension within 6 hours after surgery.Results There was a significant difference in the amount of propofol and remifentanil used during surgery between the two groups of patients(P＜0.05);There was no significant difference in surgical time and intraoperative bleeding between the two groups of patients(P＞0.05);There was a statistically significant difference in VSA scores at various time points after awakening(P＜0.05);The adverse reactions of nausea,vomi-ting,chills,and abdominal distension within 6 hours after surgery in both groups of patients were statistically significant(P＜0.05).Conclu-sion Ultrasound guided transverse fascia block in laparoscopic hysterectomy has the advantages of reducing anesthesia dosage,mild postopera-tive pain,and fewer adverse reactions,making patients more comfortable.
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