首页|不同容量罗哌卡因腹横肌平面阻滞复合全麻在腹腔镜卵巢良性肿瘤手术中的应用

不同容量罗哌卡因腹横肌平面阻滞复合全麻在腹腔镜卵巢良性肿瘤手术中的应用

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目的:探究超声引导下不同容量罗哌卡因腹横肌平面阻滞复合全麻在腹腔镜卵巢良性肿瘤手术中的临床应用效果.方法:纳入2021年6月-2023年5月本院收治的卵巢良性肿瘤患者90例,随机数字表采用简单随机分组法均分为两组,两组均接受罗哌卡因腹横肌平面阻滞复合全麻方案,超声引导下行双侧腹横肌平面阻滞,分别给予0.33%的罗哌卡因25ml(高容量组)或15ml(低容量组),待麻醉起效后行全身麻醉,观察两组神经阻滞麻醉起效时间,术中心率(HR)、平均动脉压(MAP)、术后疼痛情况和麻醉相关并发症情况.结果:高容量组神经阻滞麻醉起效时间(4.21±0.48 min)、麻醉至手术开始时间(12.38±2.19 min)均短于低容量组(4.58±0.64 min、13.97±2.35 min),不同时间点的HR、MAP均高于低容量组,术后6h运动状态下视觉模拟评分(3.96±0.35分)低于低容量组(4.12±0.40分)(均P<0.05);术后麻醉相关并发症发生率低容量组(13.3%)与高容量组(8.9%)未见差异(P>0.05).结论:腹腔镜卵巢良性肿瘤手术实施高容量罗哌卡因腹横肌平面阻滞复合全麻方案对患者HR、MAP波动较小,术后舒适度更好,未增加麻醉相关并发症.
Application of the different volumes of ropivacaine used in the transversus abdominis plane block combined with general anesthesia for patients during laparoscopic surgery of benign ovarian tumors
Objective:To observe the clinical application effect of the different volumes of ropivacaine used in the trans-versus abdominis plane block(TAPB)by the ultrasonic guidance combined with general anesthesia for patients during laparoscopic surgery of benign ovarian tumors.Methods:90 patients with benign ovarian tumors were enrolled and were randomized divided into two groups by simple randomization method using a random number table from June 2021 to May 2023.The patients in both groups received ropivacaine used in TAPB combined with general anesthesia regimen.The patients in group A were given 25ml of 0.33%ropivacaine for bilateral transversus abdominis plane block under ultrasound guidance and the patients in group B were given 25ml of 0.33%ropivacaine for bilateral transversus abdominis plane block under ultrasound guidance,and then the patients were performed general anesthesia after anes-thesia onset.The onset time of nerve block anesthesia,the values of intraoperative heart rate(HR)and mean arterial pressure(MAP),the postoperative pain status and the anesthesia-related complications of the patients in both groups were observed.Results:The onset time of the nerve block anesthesia(4.21±0.48 min)and the time from anesthesia to operation(12.38±2.19 min)of the patients in group A were significantly shorter than those(4.58±0.64 min and 13.97±2.35min)of the patients in group B.The values of HR and MAP of the patients in group A at different time points were significantly higher than those of the patients in group B.The visual analogue scale(VAS)score(3.96±0.35 points)of the patients in group A at 6 hours after operation was significantly lower than that(4.12±0.40 points)of the patients group B(all P<0.05).There was no significant difference in the incidence of the postoperative anesthesia-related complications(13.3%vs.8.9%)of the patients between the two groups(P>0.05).Conclusion:The high volume of ropivacaine used in TAPB combined with general anesthesia for the patients during laparoscopic surgery of benign ovarian tumors has less influence on their HR and MAP,and the patients has better postoperative recovery comfort,without increase of the anesthesia-related complications of the patients.

Laparoscopic surgery of benign ovarian tumorNerve blockTransversus muscle of abdomenDifferent volume of ropivacaineEffect of anesthesia and analgesia

张莉萍、黄海亮

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安徽省界首市人民医院(236500)

腹腔镜卵巢良性肿瘤手术 神经阻滞 腹横肌 不同容量罗哌卡因 麻醉镇痛效果

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(10)