摘要
目的观察腹横肌平面阻滞(TAPB)术联合右美托咪定对妇科腹腔镜手术患者苏醒质量和应激指标的影响。方法选取医院妇科接受腹腔镜手术治疗的患者120例,按随机数字表法分为A组、B组与C组,各40例。3组患者均予常规麻醉诱导,A组患者持续泵注盐酸右美托咪定注射液,B组患者于超声引导下以盐酸罗哌卡因注射液行双侧TAPB术,C组患者联用A组和B组方案。结果3组患者诱导前(T0)、手术10 min(T1)、手术30 min(T2)、手术结束(T3)、拔管时(T4)、拔管后2 min(T5)平均动脉压(MAP)与心率(HR),T4平均呼吸频率(RR)及拔管后胃肠功能恢复时间和下床活动时间比较无显著差异(P>0.05);C组术后拔管时间明显短于其余两组(P<0.05),且麻醉后复苏室(PACU)疼痛(NRS)评分及咳嗽评分均显著低于其余两组(P<0.05);C组与B组患者Ricker镇静躁动评分均显著高于A组(P<0.05);3组不良反应发生率相当(P>0.05)。结论TAPB术联合右美托咪定有利于改善妇科腹腔镜手术患者苏醒期咳嗽症状与镇静躁动情况,加快苏醒期恢复,减轻PACU疼痛,且不加剧机体应激反应。
Objective To observe the effect of transversus abdominis plane block(TAPB)combined with dexmedetomidine on recovery quality and stress indexes of patients undergoing gynecological laparoscopic surgery.Methods A total of 120 patients undergoing laparoscopic surgery from the Department of Gynecology in the hospital were selected and divided into the groups A,B,and C according to random number table method,40 cases in each group.All three groups were all induced by conventional anesthesia.Group A was given continuous pumping of dexmedetomidine hydrochloride injection,group B underwent bilateral TAPB surgery with ropivacaine hydrochloride injection under ultrasound guidance,and group C received combined treatment of group A and group B.Results There was no significant difference in the mean arterial pressure(MAP),heart rate(HR),average respiratory rate(RR),gastrointestinal function recovery time after extubation,and time of getting out of bed among the three groups at before induction(T0),10 min after surgery(T1),30 min after surgery(T2),at the end of surgery(T3),at extubation(T4),and 2 min after extubation(T5)(P>0.05).The postoperative extubation time of group C was significantly shorter than that of the other two groups(P<0.05),and the numerical rating scale(NRS)pain score and cough score of the post-anesthesia care unit(PACU)were significantly lower than those of the other two groups(P<0.05).The Ricker sedation and restlessness scores in group C and group B were significantly higher than those in group A(P<0.05);the incidence of adverse reactions in the three groups was similar(P>0.05).Conclusion TAPB combined with dexmedetomidine is more conductive to improving cough symptoms,sedation and agitation in patients undergoing gynecological laparoscopic surgery,speeding up recovery and reducing PACU pain without aggravating the body’s stress response.
作者
庞刚
周俨
李军
饶传华
PANG Gang;ZHOU Yan;LI Jun;RAO Chuanhua(Jiangjin District Central Hospital,Chongqing,China 402260)
出处
《中国药业》
CAS
2020年第18期85-88,共4页
China Pharmaceuticals
基金
重庆市江津区科技计划项目[Y2016016]。
关键词
右美托咪定
腹横肌平面阻滞
妇科
腹腔镜手术
苏醒质量
应激指标
dexmedetomidine
transversus abdominis plane block
gynecology
laparoscopic surgery
recovery quality
stress indexes
