本文選題：神經(jīng)傳導(dǎo)阻滯　切入點(diǎn)：腹肌　出處：《中國現(xiàn)代醫(yī)學(xué)雜志》2015年20期 　論文類型：期刊論文

【摘要】：目的評(píng)價(jià)腹橫肌平面(TAP)阻滯對(duì)局部麻醉下腹股溝疝修補(bǔ)術(shù)患者的臨床療效。方法選取擇期在局部麻醉下行腹股溝疝修補(bǔ)術(shù)患者60例,年齡58~82歲,采用隨機(jī)數(shù)字表法,將患者分為兩組,生理鹽水對(duì)照組(A組)和TAP阻滯組(B組),每組30例。A組注入等容量生理鹽水20 ml,B組注入0.375%羅哌卡因20 ml,阻滯成功后開始常規(guī)手術(shù)區(qū)消毒、鋪巾,局部麻醉并手術(shù)。比較兩組患者切皮反應(yīng)、術(shù)中心率變化、VAS評(píng)分、術(shù)后VAS評(píng)分及鎮(zhèn)痛總體滿意度評(píng)分,記錄TAP阻滯相關(guān)不良反應(yīng)的發(fā)生。結(jié)果 B組無患者補(bǔ)救鎮(zhèn)痛。B組術(shù)中心率、血壓平穩(wěn),術(shù)中、術(shù)后VAS評(píng)分降低,鎮(zhèn)痛總體滿意度評(píng)分與A組比較有提高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。B組未發(fā)生TAP阻滯相關(guān)不良反應(yīng)。結(jié)論 TAP阻滯對(duì)局部麻醉下腹股溝疝修補(bǔ)術(shù)患者的療效滿意,安全性較高,并能有效阻滯術(shù)中迷走神經(jīng)反射。其改進(jìn)的麻醉技術(shù)有利于在日間手術(shù)室開展腹股溝疝修補(bǔ)術(shù)。
[Abstract]:Objective to evaluate the clinical effect of TAP block on inguinal herniorrhaphy under local anesthesia. Methods 60 patients, aged 58 to 82 years, underwent selective inguinal hernia repair under local anesthesia. The patients were divided into two groups: normal saline control group (group A) and TAP block group (group B: 30 cases in each group). Group B was injected with 0.375% ropivacaine 20 ml in equal volume. After the block was successful, the routine operation area was disinfected and the towel was spread. Local anaesthesia combined with operation. The skin incision reaction, heart rate change during operation, postoperative VAS score and total satisfaction score of analgesia were compared between the two groups. Results the heart rate, blood pressure, VAS score were decreased in group B. the total satisfaction score of analgesia was higher than that in group A. There were no adverse reactions associated with TAP block in group P0.05.B.Conclusion TAP block is effective and safe in patients with inguinal hernia repair under local anesthesia. It can block vagus reflex effectively. The improved anaesthesia technique is helpful to repair inguinal hernia in daytime operating room.
【作者單位】： 天津港口醫(yī)院外科;
【分類號(hào)】：R656.21

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