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中国临床研究英文版:2025,38(6):866-870
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超声引导下横突间阻滞在腹腔镜胆囊切除术患者术后镇痛的效果
(1. 徐州医科大学盐城临床学院, 江苏 盐城 224000;2. 盐城市第一人民医院麻醉科, 江苏 盐城 224000)
Effect of ultrasound⁃guided intertransverse process block on postoperative analgesia in patients undergoing laparoscopic cholecystectomy
摘要
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Received:December 07, 2024   Published Online:June 20, 2025
中文摘要: 目的 探讨超声引导下横突间阻滞(ITPB)用于腹腔镜胆囊切除术(LC)患者术后镇痛的安全性与有效性。方法 选取 2024 年 7 月至 9 月于盐城市第一人民医院行 LC 患者 60 例,采用数字表法随机分为 ITPB组(I 组)与全麻对照组(C组)各30例。两组均行全身麻醉,I组在麻醉诱导前镇静镇痛后行超声引导下ITPB,双侧单点注射 0.3%罗哌卡因 25 mL;C 组不进行阻滞操作。记录术中瑞芬太尼、术后 24 h 内阿片类药物的消耗量,观察术后拔管即刻(T0)、5 min(T1)、10 min(T2)、20 min(T3)、30 min(T4)、1 h(T5)、2 h(T6)、6 h(T7)、24 h(T8)时的腹壁切口痛与内脏疼痛的疼痛数字评价量表(NRS)评分,记录患者术后首次下床活动时间与不良反应。结果 I 组术中瑞芬太尼的使用量与术后 24 h 内阿片类药物的消耗量明显低于 C 组(P<0.05);I 组在 T1、T2、T7时间点腹壁切口痛 NRS 评分,除 T4、T6外的 7 个时点内脏痛的 NRS 评分低于 C 组(P<0.05);与 C 组相比,I 组术后首次下床活动时间更早,术后 24 h 阿片类药物消耗量更低(P<0.05);两组术后 PACU 内舒芬太尼的使用与不良反应的发生比较,差异无统计学意义(P>0.05)。结论 ITPB 应用于LC 术后镇痛安全性好、镇痛效果确切,具有较好的临床应用价值。
Abstract:Objective To explore the safety and efficacy of ultrasound-guided inter transverse process block(ITPB)for postoperative analgesia among patients undergoing laparoscopic cholecystectomy(LC). Methods The research included60 patients scheduled for LC at Yancheng No.1 People’s Hospital from July to September 2024. Participants were randomly divided into ITPB group(group I)and general anesthesia control group(group C)with 30 cases each by digital table method. Both groups were given general anesthesia. After sedation and analgesia, group I received ultrasound ?guided ITPB with bilateral single point injection of 25 mL 0.3% ropivacaine before anesthesia induction. Group C did not undergo blocking operations. Intraoperative remifentanil and opioid consumption within 24 hours after surgery were recorded. NRS scores of abdominal incision pain and visceral pain were observed immediately after extubation(T0), 5 min(T1), 10 min(T2), 20 min(T3), 30 min(T4), 1 h(T5), 2 h(T6), 6 h(T7), and 24 h(T8)after operation. The first time of getting out of bed and the occurrence of adverse reactions were recorded. Results Compared with group C, group I had a significantly decrease in the intraoperative use of remifentanil and the consumption of opioids in 24 hours after operation(P<0.05). NRS scores of abdominal incision pain at T1, T2, T7 and visceral pain at seven time points expcept T4 and T6 in group I were lower than those of group C(P<0.05). Compared with group C, group I had earlier time to get out of bed and lower opioid consumption at 24 hours after surgery(P<0.05). There was no statistically significant difference in the use of sufentanil in PACU and the occurrence of adverse reactions between the two groups(P>0.05). Conclusion ITPB has good safety and exact analgesic effects after LC and has good clinical application value.
文章编号:     中图分类号:R614.4    文献标志码:A
基金项目:盐城市基础研究计划指导性项目(YCBK202208)
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