超声引导下腹横肌平面阻滞用于小儿下腹部手术术后镇痛的临床观察

目的观察超声引导下腹横肌平面(TAP)阻滞用于小儿下腹部手术术后镇痛的效果。方法选择择期行下腹部手术的患儿60例,随机分为观察组(A组,30例)和对照组(B组,30例),常规行氯胺酮静脉全身麻醉,术毕A组在超声引导下行TAP阻滞,注入0.33%盐酸罗哌卡因1.5 mg/kg,B组注入等量生理盐水。所有患儿术后均使用静脉自控镇痛泵。比较两组术后2、4、8、12 hCHEOPS评分、Ramesay评分,记录术后镇痛泵按压次数、镇痛满意度及不良反应。结果 A组术后24、、8、12 h CHEOPS评分明显低于B组,两组比较差异具有统计学意义(F=8.77,P<0.05)。A组术后镇痛泵按压次数明显少于B组,患儿或家长对镇痛的满意度明显高于B组,两组比较差异具有统计学意义(P<0.05)。两组患儿Ramesay评分比较差异无统计学意义(F=0.85,P>0.05)。两组均未见TAP穿刺引起的不良反应。结论超声引导下的TAP阻滞定位准确,用于小儿下腹部手术能有效镇痛,减少术后静脉镇痛药的需要量,值得临床应用。

Clinical Observation of Ultrasound-guided Transverses Abdominis Plane Block for Children Abdominal Surgery Postoperative Analgesia

Objective To observe the efficacy of ultrasound-guided transversus abdominis plane block for Children abdominal surgery postoperative analgesia.Methods 60 children who need abdominal surgery were randomly divided into the observe group(A group,n=30) and the control group(B group,n=30).Both groups received routine intravenous ketamine general anesthesia,children in group A received ultrasound-guided TAP block after surgery,injection of 0.33% ropivacaine hydrochloride 1.5mg/kg,children in group B injected wit...