超声引导下腹直肌鞘阻滞对开腹子宫全切除术后镇痛的影响被引量：2

Postoperative analgesia efficacy of ultrasound-guided rectus abdominis sheath block in patients with abdomen panhysterectomy

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摘要目的观察超声引导下腹直肌鞘阻滞（RSB）对开腹子宫全切除术后镇痛效果的影响.方法 40例全身麻醉下行开腹子宫全切除术的患者,按随机数字表法分为RSB组和对照组,每组20例,所有患者均使用患者自控静脉镇痛.比较两组术后2、6、12和24h疼痛视觉模拟量表（VAS）评分、Ramsay镇静评分,术后24h舒芬太尼消耗总量、镇痛泵总按压次数,发生恶心呕吐例数及镇痛满意度评分.结果 RSB组术后2、6、12、24 h VAS评分低于对照组相同时间点,但差异无统计学意义（P＞0.05）.所有患者Ramsay镇静评分均＜4分.术后24h,RSB组舒芬太尼消耗总量为（73.1±8.6） μg,明显低于对照组的（91.7±12.3）μg,差异有统计学意义（P＜0.01）；RSB组镇痛泵总按压次数为（6.5±2.1）次,明显少于对照组的（12.3±4.6）次,差异有统计学意义（P＜0.01）；RSB组镇痛满意度评分为（7.3±0.7）分,明显优于对照组的（6.8±1.1）分,差异有统计学意义（P＜0.05）.RSB组有4例出现恶心呕吐,而对照组有3例出现恶心呕吐,两组比较差异无统计学意义（P＞0.05）.所有患者均未观察到与RSB操作相关的并发症.结论 RSB用于开腹子宫全切除术后镇痛能明显减少静脉阿片类镇痛药用量,增加患者术后镇痛满意度. Objective To investigate the postoperative analgesia efficacy of ultrasound-guided rectus abdominis sheath block （RSB） in patients with abdomen panhysterectomy.Methods Forty patients with abdomen panhysterectomy under general anesthesia were divided into RSB group and control group by random digits table method with 20 cases each.All the patients were given patient controlled intravenous analgesia.The visual analogue scale （VAS） score and Ramsay sedative score at 2,6,12 and 24 h after operation,sulfentanyl dosage and total number of analgesic pump press of 24 h,number of nausea and vomiting,analgesic satisfaction score were recorded.Results The VAS scores in RSB group at 2,6,12,24 h after operation were lower than those in control group,but there were no statistical differences （P〉 0.05）.The Ramsay sedative score of all patients was 〈 4 scores.Sulfentanyl dosage of 24 h in RSB group was （73.1 ± 8.6） μ g,in control group was （91.7 ± 12.3） μ g,there was statistical difference （P 〈 0.01）.The number of analgesic pump press of 24 in RSB group was （6.5 ± 2.1） times,in control group was （12.3 ± 4.6）times,there was statistical difference （P 〈 0.01）.Analgesic satisfaction score in RSB group was （7.3 ± 0.7）scores,in control group was （6.8 ± 1.1） scores,there was statistical difference （P〈 0.05）.Four cases in RSB happened nausea and vomiting,3 cases in control group,there was no statistical difference （P 〉 0.05）.All patients did not happen the complication related with RSB operation.Conclusion RSB as the postoperative analgesia in patients with abdomen panhysterectomy can reduce the dosage of opioid drug,and increases the analgesic satisfaction.

作者崔湧王羿鸥孙艳红吴滨阳

机构地区中国医科大学附属第一医院麻醉科

出处《中国医师进修杂志》 2013年第30期25-27,共3页 Chinese Journal of Postgraduates of Medicine

基金辽宁省科技厅项目（2011225021）

关键词子宫切除术镇痛 Hysterectomy Analgesia

分类号 R614 [医药卫生—麻醉学]

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