摘要
目的评价超声引导下腹横肌平面阻滞(transverse abdominis plane block,TAPB)对儿童腹腔镜阑尾切除术后康复的影响。方法选取2019年2~11月首都医科大学附属北京儿童医院全麻喉罩下行腹腔镜阑尾切除手术的患儿36例,年龄6~17岁,美国麻醉医师协会(American Society of Anesthesiologist,ASA)分级Ⅰ或Ⅱ级,随机分为A、B两组,每组18例。A组采用肛塞小儿布洛芬栓;B组采用肛塞小儿布洛芬栓复合TAPB技术。分别记录术后1、3、6、12、24 h的静息疼痛评分和咳嗽疼痛评分,以及自主坐起活动和自主下地活动情况。同时记录两组术后躁动等相关不良反应及并发症的发生率。结果B组术后各时间点的静息VAS及咳嗽VAS均低于A组(P<0.05)。B组术后3 h自主坐起、术后6 h自主坐起和下地活动比例均显著高于A组(P<0.05)。结论超声引导下TAPB用于儿童腹腔镜阑尾切除术可提供术后早期良好的镇痛效果,促进术后早期自主活动,有利于术后康复。
Objective To evaluate the effect of ultrasound-guided transverse abdominis plane block(TAPB)on recovery after laparoscopic appendectomy in children.Methods Thirty-six patients,aged 6 to 17 years old,American Society of Anesthesiologist(ASA)ⅠorⅡ,were enrolled in this study from February to November 2019.They were randomly divided into two groups(n=18 each),group A was received paediatric ibuprofen suppositories rectally,group B was received paediatric ibuprofen suppositories rectally combined with TAPB.Visual analogue scores(VAS)both at resting and coughing at postoperative 1,3,6,12,and 24 h were recorded,sitting and standing movements were also recorded.The incidence of adverse reactions and complications were also recorded.Results Compared with group A,VAS at each postoperative time point was significantly decreased in group B(P<0.05),the ratio of the patients who can sitting up at postoperative 3 and 6 h,and who can standing up at postoperative 6 h,was significantly increased in group B(P<0.05).Conclusions Ultrasound-guided TAPB used in laparoscopic appendectomy of children can provide good analgesic effect in the early postoperative period,enhance the willingness to sit up and move to the ground in the early stage,which may be beneficial to the postoperative recovery.
作者
邹楠
张建敏
郑超
高佳
高铮铮
王芳
Zou Nan;Zhang Jianmin;Zheng Chao;Gao Jia;Gao Zhengzheng;Wang Fang(Department of Anesthesiology,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)
出处
《北京医学》
CAS
2020年第5期417-420,共4页
Beijing Medical Journal
关键词
腹横肌平面阻滞
加速康复外科
腹腔镜
阑尾切除术
儿童
transverse abdominis plane block(TAPB)
enhanced recovery after surgery(ERAS)
laparoscope
appendicectomy
child
