摘要
目的 比较对腹腔镜阑尾切除术患者分别应用超声引导下神经阻滞镇痛的效果.方法 选取2022年10月至2023年10月于盘州市人民医院行腹腔镜阑尾切除术的患者70例,随机划分为研究组(右侧腹横肌平面阻滞联合双侧腹直肌鞘阻滞术后镇痛)与对照组(右侧腹横肌平面阻滞术后镇痛),每组各35例,对比分析两组血流动力学指标,随访腹腔镜阑尾切除术患者镇痛效果、术后并发症发生率.结果 两组心率、平均动脉压、SpO2差异在出手术室时无统计学意义(P＞0.05),术后4h、12h研究组MAP、心率低于对照组,SpO2值高于对照组,差异有统计学意义(P＜0.05);两组术后2h的VAS评分比较差异无统计学意义(P＞0.05),研究组术后4h、12h、24h的VAS评分均低于对照组,差异有统计学意义(P＜0.05);研究组并发症1例(2.86％),低于对照组的10例(28.57％),差异有统计学意义(P＜0.05).结论 对接受腹腔镜阑尾切除术患者积极进行镇痛干预,结果显示超声引导下右侧腹横肌平面联合双侧腹直肌鞘阻滞的方式能明显提升镇痛效果,血流动力学指标较平稳,安全性更高.
Abstract
Objective To compare the analgesic effect of ultrasound-guided nerve block in patients with laparoscopic appendectomy.Methods 70 patients who underwent laparoscopic appendectomy in our hospital from October 2022 to October 2023 were selected and randomly divided into the study group(right transverse abdominis plane block combined with bilateral rectus sheath block with postoperative analgesia)and the control group(right transverse abdominis plane block with postoperative analgesia),with 35 cases in each case.The hemodynamic indexes were compared and analyzed.The analgesic effect and postoperative complication rate for postoperative analgesia in laparoscopic appendectomy patients were followed up.Results There was no statistical significant difference in HR,MAP,and SPO2 between the two groups at the time of leaving the operating room(P＞0.05).The MAP and HR values of the study group were lower than those of the control group at 4h and 12h after surgery,and the SpO2 values of the study group were higher than those of the control group,the statistical results were significantly different(P＜0.05).There was no statistical significant difference in VAS score between the two groups at 2h after surgery(P＞0.05).VAS scores of the study group at 4h,12h,and 24h after surgery were lower than those of the control group,and the statistical results were significantly different(P＜0.05).The complications in the study group(1 case)(2.86％)were less than those in the control group(10 cases)(28.57％),the difference was statistically significant(P＜0.05).Conclusion Active analgesic intervention for patients undergoing laparoscopic appendectomy shows that ultrasound-guided right transverse abdominal muscle plane combined with bilateral sheath block of rectus abdominal muscle can significantly improve the analgesic effect with stable hemodynamic indexes and higher safety.
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