首页|超声引导下弓状韧带上腰方肌前侧阻滞复合全麻用于腹腔镜全子宫切除术效果

超声引导下弓状韧带上腰方肌前侧阻滞复合全麻用于腹腔镜全子宫切除术效果

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目的:探讨腹腔镜全子宫切除术应用超声引导下弓状韧带上腰方肌前侧阻滞复合全身麻醉镇痛效果.方法:纳入本院2023年4-12月拟行腹腔镜全子宫切除术患者102例,随机分为对照组和观察组各51例,对照组采用单纯插管的全身麻醉,观察组利用超声引导下弓状韧带上腰方肌前侧阻滞复合全身麻醉.记录并比较两组术中瑞芬太尼和丙泊酚使用剂量,术后不同时点静息状态下患者的疼痛程度、镇痛药物使用次数、应激反应及术后不良反应.结果:观察组术中瑞芬太尼(1.76±0.27 mg)和丙泊酚(241.33±27.55 mg)使用剂量均低于对照组(1.96±0.26 mg、295.63±26.95 mg),术后静息状态下视觉模拟评分、术后镇痛药物使用次数,以及平均动脉压和心率变化幅度均低于对照组(P<0.05).两组术后不良反应(9.8%、15.7%)无差异(P>0.05).结论:针对接受腹腔镜全子宫切除术治疗的患者,将超声引导下双侧弓状韧带上腰方肌阻滞复合全身麻醉,可有效地降低麻醉过程中的药物使用剂量,改善术后疼痛程度,减少补救镇痛次数和缓解手术应激反应,具有良好的安全性.
Effect of ultrasound-guided anterior block of superior arcuate ligament quadrate musculi lumbosum combined with general anesthesia during laparoscopic total hysterectomy
Objective:To investigate the anesthesia and effect of ultrasound-guided anterior block of superior arcuate ligament quadrate musculi lumbosum combined with general anesthesia during laparoscopic total hysterectomy of pa-tients.Methods:From April 2023 to December 2023,102 patients who wanted laparoscopic total hysterectomy in the hospital were selected and were randomly divided into two groups(51 cases in each group).The patients in the control group were given general anesthesia with simple intubation during surgery and the patients in the observation group were given ultrasound-guided anterior block of quadrate lumbosi muscle superior arcuate ligament combined with gen-eral anesthesia.The dosages of remifentanil and propofol used during operation,the degree of pain at different time points after operation,the frequency of analgesic drug used,the stress response and the adverse reactions rate of the patients were recorded and were compared between the two groups.Results:The dosages of remifentanil(1.76±0.27 mg)and propofol(241.33±27.55 mg)of the the patients in the observation group were significantly lower than those(1.96±0.26 mg and 295.63±26.95 mg)of the patients in the control group.The postoperative visual analogue scale(VAS)score at resting state,the number of postoperative analgesics used and the values changes of mean arterial pres-sure(MAP)and heart rate(HR)of the patients in the observation group were significantly lower than those of the pa-tients in the control group(P<0.05).There was no significant difference in the postoperative adverse reaction rate(9.8%vs.15.7%)of the patients between the two groups(P>0.05).Conclusion:Ultrasound-guided anterior block of superior arcuate ligament quadrate musculi lumbosum combined with general anesthesia during laparoscopic total hysterectomy of the patients can effectively reduce the dosages of the anesthesic drugs used,improve the postop-erative pain,reduce the number of remedial analgesics and alleviate surgical stress reactions of the patients,and with good safety.

Laparoscopic total hysterectomyUltrasound-guided anesthesiaAnterior block of superior arcuate liga-ment quadrate musculi lumbosumAnalgesiaAdverse reaction

秦俊、董翔宇

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华中科技大学同济医学院附属协和医院(武汉,430022)

腹腔镜全子宫切除术 超声引导下麻醉 弓状韧带上腰方肌前侧阻滞 镇痛 不良反应

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(6)
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