超声引导下腹横肌平面阻滞用于老年患者腹股沟疝修补术的临床研究 |
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引用本文: | 徐尚军,秦忠芳,张利权,杨光艳,林佳鹤,常向红,陈东升,周国庆. 超声引导下腹横肌平面阻滞用于老年患者腹股沟疝修补术的临床研究[J]. 国际麻醉学与复苏杂志, 2016, 0(8): 684-687. DOI: 10.3760/cma.j.issn.1673-4378.2016.08.004 |
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作者姓名: | 徐尚军 秦忠芳 张利权 杨光艳 林佳鹤 常向红 陈东升 周国庆 |
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作者单位: | 首都医科大学平谷医院麻醉科,北京,101200 |
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摘 要: | 目的 探讨超声引导下腹横肌平面(transversus abdominis plane,TAP)阻滞用于老年患者腹股沟疝修补术的安全性和有效性. 方法 选择择期行腹股沟疝修补术65岁以上老年患者60例,ASA分级Ⅰ~Ⅲ级,采用随机数字表法分为TAP阻滞组(A组)和局部浸润麻醉组(B组),每组30例.记录麻醉前(T0)、手术开始(T1)、手术开始后15 min(T2)、手术开始后30 min(T3)及手术结束(T4)时的MAP和HR;记录术后4、8、12、24h的VAS评分,追加镇痛药的例数;记录麻醉相关并发症;于术后48 h行患者麻醉满意度评价. 结果 A组术后4、8、12 h VAS评分[2(1~2)、2(1~2)、1(0~1)]均低于同时点B组[3(2~3)、3(2~3)、1(0~1)],差异有统计学意义(P<0.05).术后镇痛药追加例数A组为0例,B组为20例(66.7%),差异有统计学意义(P<0.05).A组总体满意度(93%)明显高于B组(73%),差异有统计学意义(P<0.05). 结论 超声引导下TAP阻滞用于老年患者腹股沟疝修补术效果确切,对血流动力学影响小,可减少术后镇痛药用量,且患者的总体满意度高.
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关 键 词: | 超声 腹横肌平面 老年患者 疝修补术 |
A clinical trial of ultrasound-guided transversus abdominis plane block for elderly patients undergoing inguinal hernia repair |
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Abstract: | Objective To evaluate the effect and safety of ultrasound-guided transversus abdominis plane (TAP) block for elderly patients undergoing inguinal hernia repair.Methods Sixty patients scheduled for inguinal hernia repair,ASA Ⅰ-Ⅲ,over 65 years,were randomly divided into two groups (n=30):TAP block group (group A) and local anesthesia group (group B).MAP and HR were recorded before anesthesia (T0),before operation (T1),15 min (T2),30 min (T3) after the start of the operation and after operation (T4).VAS scores and the number of patients requiring rescue analgesics were recorded at 4,8,12,24 h after operation.Anesthesia complications were recorded.The overall satisfaction of analgesia were recorded from the patients in 48 h.Results The VAS scores were lower at 4,8,12 h after operation in group A [2(1-2),2(1-2),1(0-1)] than that in group B [3(2-3),3(2-3),1(0-1)] (P<0.05).The number of patients requiring rescue analgesics were lower after operation in group A [0 (0%)] than that in group B [20 (66.7%)] (P<0.05).The overall satisfaction of analgesia from the patients in group A was higher than that in group B(93% vs 73%)(P< 0.05).Conclusions Ultrasound-guided TAP block is an effective anesthesia method which has less hemodynamic effects to elderly patients undergoing inguinal hernia repair,it can significantly reduce the consumption of analgesics and improve the overall satisfaction of analgesia from the patients. |
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Keywords: | Ultrasound Transversus abdominis plane Elderly patient Herniorrhaphy |
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