急诊阑尾切除术中超声引导腹横肌平面阻滞的镇痛效果

目的：探讨全麻急诊阑尾切除术中超声引导腹横肌平面阻滞的镇痛效果。方法全麻下接受急诊开腹阑尾切除术患者50例，采用计算机排序分为A、B组各25例，分别予以超声引导腹横肌平面阻滞和常规麻醉。观察并记录48 h内各随访时点运动与静息时的数字评分（ NRS），使用镇痛药物辅助的病例数，患者对术后疼痛缓解自我评分以及镇痛相关并发症。结果在12 h内各时点静息与运动时的NRS评分，A组明显低于B组（ P＜0.05），24～48 h各时点两组间比较差异无统计学意义（P ＞0.05）。 A组患者术后疼痛缓解自我评分明显高于B组（P＜0.05）。术后第一日和第二日辅助镇痛药使用率A组低于B组（ P＜0.05）。结论超声引导下腹横肌平面阻滞可以产生良好12小时左右的术后镇痛。在多模式镇痛中可能更占优势。

A study of postoperative pain control by ultrasound-guided transversus abdominis plane blocks for appendectomy

Objective To investigate the analgesic efficacy of transversus abdominal plane （ TAP） blocks after emergency ap-pendectomy under general anesthesia .Methods Fifty adult patients undergoing open appendectomy were randomized to undergo a right-sided TAP blocks （ group A） after surgery or a standard care （ group B） .Quality of the patients＆#39;pain was evaluated by a numeri-cal rating scale （NRS）） at rest and movement.The incidence of using analgesic medications ,relief of postoperative pain rated by pa-tients themselves and analgesia-related complications such as vomiting ,pruritus and somnolence were recorded in all patients .Results At postoperative 12 h time point,NRS movement and rest scores in the group A were significantly lower than that in the group B （P〈0.05 ） .However ,no difference was found after 24 h of surgery between the two groups .The scores of relief of postoperative pain as-sessed by patients themselves in the group A were significantly higher than that in the group B （ P〈0.05 ） .On the first and second day after surgery,the analgesic usage in the group A were more than that in the group B （P 〈0.05）.Conclusion TAP blocks may pro-duce good postoperative analgesia in 12 h after open appendectomy .TAP may play a critical role in multimodal analgesia.