摘要
目的观察超声引导下腹横筋膜阻滞(TAPB)在老年患者结直肠癌根治术的安全性及对术中瑞芬太尼用量和七氟烷浓度的影响。方法选择择期经腹行结直肠癌根治术老年患者60例,随机分为TAPB组与对照组(N组),各30例。TAPB组在超声引导下行双侧TAPB;对照组不阻滞。观察两组术前(T0)、手术开始(T1)、手术结束时(T2)、拔管时(T3)的平均动脉压(MAP)、心率(HR);统计两组术中瑞芬太尼用量及平均呼气末肺泡内七氟醚浓度;比较两组手术时间、拔管时间、苏醒时间及苏醒期躁动情况。结果 (1)TAPB组T1、T2的MAP均低于N组;(2)TAPB组瑞芬太尼用量及平均呼气末肺泡内七氟醚浓度明显低于N组(P <0.05);(3)两组手术时间无统计学差异(P> 0.05),但TAPB组拔管时间、苏醒时间及苏醒期躁动情况明显低于N组(P <0.05)。结论超声引导下TAPB阻滞用于老年结直肠癌根治术,能够有效降低麻醉药物用量,患者术中血流动力学更稳定,术后苏醒快,不良反应小,值得临床推广。
Objective To observe the safety of ultrasound-guided transversus abdominis plane block(TAPB) in radical resection of colorectal cancer for the elderly patients and its effect on the intraoperative dosage of remifentanil and concentration of sevoflurane.Methods A total of 60 elderly patients receiving elective radical transabdominal resection of colorectal cancer was selected and randomly divided into TAPB group and control group(group N), with 30 cases each. Ultrasound-guided bilateral TAPB was performed for the TAPB group, and no blocks were performed for the control group. The mean arterial pressure(MAP) and heart rate(HR) of both groups were observed prior to the operation(T0), at the beginning of the operation(T1), at the end of the operation(T2) and at extubation(T3);the intraoperative dosage of remifentanil and the mean end-expiratory concentration of sevoflurane in alveolar were counted for both groups;operation time, extubation time, recovery time and the dysphoria in the recovery stage were compared between the two groups. Results(1) MAP of the TAPB group was lower than that of group N at both T1 and T2;(2) The dosage of remifentanil and the mean end-expiratory concentration of sevoflurane in alveolar were significantly lower than that of group N(P <0.05);(3) There was no statistical difference in operation time between the two groups(P > 0.05), while the extubation time, recovery time and the frequency of dysphoria in the recovery stage were significantly lower than those of group N(P < 0.05). Conclusion Application of ultrasound-guided TAPB in radical resection of colorectal cancer for the elderly patients can effectively cut down the dosage of anesthetic drugs and improve the stability of intraoperative hemodynamics. In addition, patients recover faster after operation with less adverse reactions, which is worthy of clinical promotion.
作者
汪海洋
辜敏
韩昌龙
龚华渠
林露
Wang Haiyang;Gu Min;Han Changlong;Gong Huaqu;Lin Lu(Department of Anesthesiology, General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, China;Department of Anesthesiology, Chengdu First People's Hospital, Chengdu,Sichuan, 610017, China;Department of Anesthesiology, Shidong Hospital, Yangpu District, Shanghai, 200438, China)
出处
《西南国防医药》
CAS
2019年第9期929-931,共3页
Medical Journal of National Defending Forces in Southwest China
