摘要
目的:探究在急腹症患者手术中,采用超声引导下平面阻滞进行麻醉对患者术后镇痛效果及炎性因子的影响。方法:将收治并进行腹腔镜手术治疗的100例急腹症患者作为研究对象,将100例患者按照随机数字表法随机分为观察组和对照组(各50例)。观察组患者于麻醉诱导前进行超声引导下腹横肌平面阻滞,对照组患者进行单纯全身麻醉。(1)对两组患者术中出血量、瑞芬太尼用量、舒芬太尼用量以及手术时间进行记录并比较;(2)测定并比较两组患者围术期各时刻体内血清炎性因子白细胞介素-6(IL-6)表达水平;(3)对两组患者术后镇痛泵按压次数以及镇痛补救例数进行比较;(4)比较两组患者术后不同时间点的疼痛状况;(5)比较两组患者治疗后不良反应的发生情况。结果:(1)两组患者术中出血量水平无统计学差异(P>0.05),观察组瑞芬太尼用量明显少于对照组,手术时间明显少于对照组(均P<0.05);(2)与术前相比,术后即刻、术后6 h以及术后24 h两组患者的IL-6水平均呈现先升高后下降的趋势;与对照组相比,术后即刻、术后6 h以及术后24 h观察组患者IL-6水平明显降低(均P<0.05);(3)观察组术后镇痛泵按压次数以及镇痛补救例数明显少于对照组(均P<0.05);(4)术后1 d、术后6、 12、24 h及术后48 h观察组患者VAS评分明显低于对照组(均P<0.05);(5)观察组患者术后不良反应情况明显低于对照组(P<0.05)。结论:急腹症患者手术治疗中,采取超声引导下平面阻滞进行麻醉,能够降低患者体内炎症反应,改善患者术后的疼痛状况,具有很好的镇痛疗效,同时患者术后不良反应的发生风险也显著降低,临床安全性更有保障。
Objective:To explore the effect of ultrasound-guided planar block anesthesia on the postoperative analgesia and inflammatory factors in patients with acute abdomen surgery.Methods:A total of 100 patients with acute abdomen who were treated by laparoscopic surgery were selected as the research objects,and they were randomly divided into the observation group and the control group according to the random number table method,50 cases in each.Patients in the observation group were subjected to ultrasound-guided transversus abdominis plane block before anesthesia induction,while patients in the control group were subjected to general anesthesia alone.The intraoperative blood loss,remifentanil dosage,sufentanil dosage and operation time of the two groups were recorded and compared.The expression levels of serum inflammatory factor IL-6 were measured and compared between the two groups at each time during the perioperative period.The number of postoperative analgesic pump compressions and the number of analgesic rescue cases were compared between the two groups.The pain status of the two groups at at different time points after operation were compared.The occurrences of adverse reactions after treatment between the two groups were compared.Results:There was no significant difference in intraoperative blood loss between the two groups(P>0.05),while the dosage of remifentanil in the observation group was significantly less than that in the control group,and the operation time was significantly shorter than that in the control group(all P<0.05).Compared with preoperative,the IL-6 levels in the two groups showed a trend of increasing first and then decreasing immediately after operation,6 hours after operation and 24 hours after operation;compared with the control group,the IL-6 levels of patients in the observation group were significantly lower in the immediate postoperative period,6 hours after operation and 24 hours after operation(all P<0.05).The number of postoperative analgesic pump pressings and the number of analgesic rescue cases in the observation group were significantly less than those in the control group(all P<0.05).The VAS scores of the observation group were significantly lower than those of the control group at 1 day,6 hours,12 hours,24 hours and 48 hours after operation(all P<0.05).The incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:In the surgical treatment of patients with acute abdomen,the use of ultrasound-guided plane block for anesthesia can reduce the inflammatory response,improve the postoperative pain status,and has a good analgesic effect.At the same time,the risk of postoperative adverse reactions is also significantly reduced,and the clinical safety is more guaranteed.
作者
折甜甜
ZHE Tiantian(Department of Anesthesiology,Xidian Group Hospital,Xi’an 710077,China)
出处
《陕西医学杂志》
CAS
2022年第10期1278-1281,共4页
Shaanxi Medical Journal
关键词
超声引导
腹横肌平面阻滞
全麻
急腹症
镇痛
炎症反应
Ultrasound guidance
Transversus abdominis plane block
General anesthesia
Acute abdomen
Analgesia
Inflammatory response
