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| 双侧胸横肌平面阻滞对心脏外科手术患者术后快速康复的影响 |
| Effect of bilateral transversus thoracis muscle plane block on fast track recovery after cardiac surgery |
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| DOI：10.12089/jca.2020.04.006 |
| 中文关键词: 胸横肌平面阻滞 超声 舒芬太尼 术后快速康复 |
| 英文关键词: Transversus thoracis muscle plane block Ultrasound Sufentanil Enhanced recovery after surgery |
| 基金项目:江西省卫生计生委中医药科研课题(2018A127);江西省卫生健康委员会科技计划(20203190) |
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| 中文摘要: |
目的 评价超声引导下双侧胸横肌平面(TTMP)阻滞对心脏外科手术患者术后快速康复的影响。
方法 选择择期心脏外科手术患者60例,男33例,女27例,年龄18～60岁,ASA Ⅱ或Ⅲ级,随机分为两组:TTMP阻滞组和对照组,每组30例。麻醉诱导前,TTMP组患者双侧采用超声引导下平面内进针技术将0.25%罗哌卡因20 ml注射在肋间内肌和胸横肌之间的平面。对照组未进行阻滞操作。记录术中舒芬太尼用量、术后舒芬太尼用量、术后机械通气时间、术后引流管拔除时间、ICU滞留时间、拔管后再次插管、出ICU后再次转入、术后恶心呕吐发生情况及住院时间。
结果 与对照组比较,TTMP组术中及术后舒芬太尼用量明显减少(P<0.01),术后机械通气时间及引流管拔除时间、ICU滞留时间明显缩短(P<0.05)，术后恶心呕吐发生率明显降低(P<0.05),住院时间明显缩短(P<0.05)。两组拔管后再次插管率及出ICU后再次转入率差异无统计学意义。
结论 双侧TTMP阻滞可为开胸心脏手术患者提供良好的围术期镇痛并促进患者的术后康复。 |
| 英文摘要: |
Objective To evaluate the effect of bilateral transversus thoracis muscle plane (TTMP) block on fast track in patients undergoing cardiac surgery.
Methods Sixty patients scheduled for elective cardiac surgery, 33 males and 27 females, aged 18-60 years, falling into ASA physical status Ⅱ or Ⅲ, were randomly divided into two groups: control group and TTMP group, n = 30 for each group. The dosage of sufentanil in operation, sufentanil after operation, mechanical ventilation time after operation, drainage tube removal time after operation, ICU retention time, re-intubation rate after extubation, re-entry rate after extubation, incidence of nausea and vomiting and hospitalization days were recorded.
Results Compared with the control group, the total amount of sufentanil in the TTMP group decreased significantly during and after operation (P < 0.01), and the removal time of tracheal tube and drainage tube and ICU retention time were shorter after operation (P < 0.05). The incidence of nausea and vomiting of the TTMP group was lower than those of the control group (P < 0.05), and the hospitalization time of the TTMP group was shorter than that of the control group (P < 0.05). There were no significant differences in the re-intubation rate and re-entry rate after extubation between the two groups.
Conclusion Bilateral TTMP block provides effective perioperative pain relief and promotes recovery in patients undergoing open cardiac surgery. |
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