【摘要】：目的探討超聲引導(dǎo)腹橫肌平面(TAP)阻滯對(duì)卵巢癌根治術(shù)中七氟醚濃度的影響。方法全麻下行卵巢癌根治術(shù)患者隨機(jī)、單盲法分為術(shù)前TAP阻滯組(T組)和對(duì)照組(C組)。記錄麻醉誘導(dǎo)前、切皮前2 min至切皮后5 min中每分鐘的心率、平均動(dòng)脈壓及七氟醚濃度。采用改良上下交叉點(diǎn)法計(jì)算得出每組的抑制腎上腺素能反應(yīng)呼氣末肺泡內(nèi)最低有效濃度(MACBAR)。同時(shí)觀察患者拔管時(shí)間及蘇醒期躁動(dòng)情況,并做評(píng)分記錄。結(jié)果 2組患者年齡、身高、體質(zhì)量、麻醉誘導(dǎo)前基礎(chǔ)心率及平均動(dòng)脈壓比較無明顯差別(P0.05)。C組平均七氟醚MACBAR為(4.16±0.42)%,T組為(1.96±0.37)%,2組比較有顯著差別(P0.05)。平均拔管時(shí)間為C組(7.2±1.5)min,T組(3.5±1.1)min,具有統(tǒng)計(jì)學(xué)差異(P0.05)。C組患者術(shù)后發(fā)生躁動(dòng)12/20,T組3/20,2組有顯著差異(P0.05)。結(jié)論超聲引導(dǎo)腹橫肌平面阻滯在婦科卵巢癌根治術(shù)中能夠有效鎮(zhèn)痛,降低七氟醚用量,縮短術(shù)后蘇醒時(shí)間、減少術(shù)后躁動(dòng)的發(fā)生。
[Abstract]:Objective to investigate the effect of ultrasound guided abdominal transverse muscle level (TAP) block on sevoflurane concentration in radical resection of ovarian cancer. Methods patients undergoing radical ovarian cancer surgery under general anesthesia were randomly divided into preoperative TAP block group (T group) and control group (C group). Heart rate, mean arterial pressure and sevoflurane concentration were recorded at 2 min before anesthesia induction and 5 min after incision. The lowest effective concentration of (MACBAR). In the end of expiratory alveolar response was calculated by using the improved method of intersecting the upper and lower intersections of each group in order to inhibit adrenergic response. At the same time, the time of extubation and restlessness during recovery were observed, and the score was recorded. Results there was no significant difference in age, height, body weight, basal heart rate and mean arterial pressure between the two groups (P0.05). The average MACBAR of sevoflurane in group C was (4.16 鹵0.42) vs (1.96 鹵0.37) in group T (P0.05). The mean extubation time was (7.2 鹵1.5) min in group C (3.5 鹵1.1 min), with statistical difference (P0.05). Conclusion Ultrasound-guided abdominal transverse muscle block can effectively analgesia, reduce the dosage of sevoflurane, shorten the recovery time and reduce postoperative restlessness in gynecologic ovarian cancer.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院麻醉科;
【基金】：遼寧省博士科研啟動(dòng)項(xiàng)目(20141035)
【分類號(hào)】：R614.1;R737.31

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