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| 超声引导下腰方肌阻滞或腹横肌平面阻滞联合舒芬太尼PCIA在阑尾切除术后镇痛中的比较 |
| Comparison of ultrasound-guided quadratus lumborum block and transversus abdominis plane block combined with patient controlled intravenous analgesia with sufentanil on post-operation analgesia after appendectomy |
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| DOI： |
| 中文关键词: 腰方肌 腹横肌平面 阑尾切除 术后镇痛 |
| 英文关键词: Quadratus lumborum block Transversus abdominis plane block Appendectomy Postoperative analgesia |
| 基金项目:陕西省社会发展科技攻关项目(2016SF-111) |
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| 中文摘要: |
目的：比较腰方肌阻滞(quadratus lumborum block,QLB)与腹横肌平面(transversus abdominis plane,TAP)阻滞联合舒芬太尼经静脉患者自控镇痛(patient controlled intravenous analgesia,PCIA)在阑尾切除术后镇痛中的效果。
方法：选择拟于腰-硬联合麻醉下行阑尾切除的患者77例,男44例,女33例,ASA Ⅰ或Ⅱ级,随机分为QLB组(n=39)和TAP组(n=38)。术后于超声引导下分别在腰方肌后表面以及腹内斜肌和腹横肌之间给予0.25％罗哌卡因20 ml。记录术后4、8、12、24、48 h舒芬太尼的消耗量及静息VAS评分;记录术后恶心呕吐、眩晕、皮肤瘙痒等不良反应的发生情况。
结果：术后12～48 h QLB组舒芬太尼消耗量明显少于TAP组(P＜0.05)。两组不同时点静息VAS评分差异无统计学意义。QLB组术后恶心呕吐[2(5.1%) vs 8(21.0%)]、眩晕[4(10.2%) vs 11(28.9%)]的发生率明显低于TAP组(P＜0.05)。
结论：QLB较TAP阻滞能够更加有效地减少术后舒芬太尼用量及不良反应的发生。 |
| 英文摘要: |
Objective: To observe the difference of quadratus lumborum block (QLB) and transversus abdominis plane (TAP) block combined with patient controlled intravenous analgesia with sufentanil in analgesia after appendectomy.
Methods: Seventy-seven patients undergoing appendectomy, including 44 patients males and 33 patients females, all falling into ASA Ⅰ or Ⅱ, were randomized into group QLB (n=39) and group TAP block (n=38). ultrasound-guided QLB and TAP block was performed at the end of operation and 0.25％ ropivacaine hydrochloride 20 ml was used. Postoperative VAS score and the consumption of sufentanil at 4, 8, 12, 24 and 48 h was recorded. Postoperative nausea and vomiting, dizziness, skin itching were recorded.
Results: Patients in group QLB used significantly less sufentanil than that of group TAP (P＜0.05) at 12, 24, 48 h and VAS score has no differences after operation. Side effects like postoperative nausea and vomiting [2(5.1%) vs 8(21.0%)], and dizziness [4(10.2%) vs 11(28.9%)] were significantly less (P＜0.05).
Conclusion: QLB can more effectively reduce postoperative sufentanil consumption and side effect than TAP block. |
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