摘要
目的探讨可视化经侧入路腹横肌平面(Transversus abdominis plane,TAP)阻滞麻醉在腹膜透析置管术中的应用优势。方法纳入2016年08月～2017年8月就诊于成都市第三人民医院,拟行腹膜透析置管术的终末期肾病患者40例。采用随机数字表法分为TAP阻滞组和局部麻醉组,每组各20例,对两组患者进行术中及术后观察点视觉模拟评分(Visual analogue scale,VAS);对两组患者VAS评分,记录手术时间、术中追加麻醉药品用量、术后使用止痛药物的患者数量、手术医生麻醉满意度、患者手术满意度,记录麻醉不良反应及结局指标的发生情况。结果 TAP阻滞组在术中各观察点VAS评分及术后VAS评分均低于局部麻醉组,差异均有统计学意义(P<0.05);TAP阻滞组术中使用罗哌卡因注射液总量上明显低于局部麻醉组,差异有统计学意义(P<0.05);TAP阻滞组在手术医生麻醉满意度及术后患者手术满意度上,明显高于局部麻醉组(P<0.05);两组患者麻醉不良反应差异无统计学意义(P>0.05),在随访结局指标上,TAP阻滞组优于局部浸润麻醉组(P<0.05)。结论可视化经侧入路腹横肌平面阻滞用于腹膜透析置管术中是一种微创、安全、有效的麻醉方式。
Objective To investigate the application advantages of the visual lateral approach transversus abdominis plane(TAP)block anesthesia under ultrasonographic visualization infor peritoneal dialysisthe application of PD catheter insertion.Methods We analyzed 40 patients from the third people’s Hospital of Chengdu with end-stage renal disease underwent PD catheter insertion between August 2016 to August 2017.The patients were randomly divided into TAP block group and local anesthesia group 20 cases in each group.The score of visual analogue scale(VAS)were record during and after the surgery.We recorded operation time,the dosage of additional anesthesia drug,and the number of patients used postoperative analgesic,doctors and patients satisfaction,and the occurrence of adverse reaction,and outcome cases.Results Each of 20 patients were included in the local anesthesia group while the other 20 cases inand the TAP block group.The VAS scores during and after the surgery in the TAP block group were lower than those in the local anesthesia group.There were significant differences(P<0.05).The TAP block group was used less consumption of ropivacaine during the operation than the local anesthesia group(38±11.74 ml vs 54±9.26 ml,t=4.78,P<0.05).The anesthetic satisfaction of the surgeon and the postoperative patient’s satisfaction and was significantly higher in the TAP block group than in than the local anesthesia group in the anesthetic satisfaction of the surgeon and the postoperative patient’s satisfaction(χ^2=4.91;χ^2=8.12,P<0.05).There was no significant difference between the two groups in the adverse reaction of anaesthesia(P >0.05).The outcome offor follow-up of the TAP block group is superior to the local anesthesia group(χ^2=20.42,P<0.05).Conclusion The visual lateral approach TAP block for peritoneal dialysis catheter is a minimally invasive,safe,and effective anesthesia.
作者
吴丹
金骊珠
龚蓉
全大勇
夏克枢
郑传东
WU Dan;JING Lizhu;GONG Rong;QUAN Dayong;XIA Keshu;ZHENG Chuandong(Department of Nephrology,The Second Affiliated Hospital of Chengdu,Chongqing Medical University,The Third People's Hospital of Chengdu,Chengdu 610031,China;Department of Anesthesiology,The Second Affiliated Hospital of Chengdu,Chongqing Medical University,The Third People's Hospital of Chengdu,Chengdu 610031,China)
出处
《西部医学》
2019年第2期232-236,共5页
Medical Journal of West China
基金
成都市医学科研课题(2017003)
关键词
腹膜透析置管术
腹横肌平面阻滞
可视化透析置管术
Peritoneal dialysis catheter placement
Transversus abdominis plane block
Visualization
Dialysis catheterization
