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1. 重庆市涪陵中心医院麻醉疼痛科
2. 重庆市涪陵中心医院输血科
纸质出版日期:2020,
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[1]李飞,李霞,李聪,李彬,陈兰.超声引导不同入路腹横肌平面阻滞在小儿腹股沟疝手术的应用效果比较[J].西南医科大学学报,2020,43(06):601-606.
LI Fei, LI Xia, LI Cong, et al. Comparison of the effects of ultrasound-guided transversus abdominis plane block using different approaches in inguinal hernia surgery in children[J]. Journal of Southwest Medical University, 2020,43(6):601-606.
[1]李飞,李霞,李聪,李彬,陈兰.超声引导不同入路腹横肌平面阻滞在小儿腹股沟疝手术的应用效果比较[J].西南医科大学学报,2020,43(06):601-606. DOI:
LI Fei, LI Xia, LI Cong, et al. Comparison of the effects of ultrasound-guided transversus abdominis plane block using different approaches in inguinal hernia surgery in children[J]. Journal of Southwest Medical University, 2020,43(6):601-606. DOI:
目的:探究超声引导下不同入路腹横肌平面(transverse abdominis plane
TAP)阻滞对小儿腹股沟疝手术的应用效果
为小儿行腹横肌平面阻滞麻醉提供参考。方法:90例行腹股沟疝手术患儿分为三组
每组30例:LAT组(腋前线侧边入路)
LSC组(肋缘下与髂前上棘连线入路)
Ⅱ组(髂前上棘内下入路)
观察记录以下指标:麻醉用药量
手术时长、苏醒时长及超声引导操作时长
术中体动、术后恶心呕吐
术后2、4、6、12、24 h东安大略儿童医院疼痛评分(children’s hospital of eastern ontario pain scale
CHEOPS)。结果:三组患儿罗哌卡因、舒芬太尼、丙泊酚用药量比较差异无统计学意义(P> 0.05);三组患儿手术时长、苏醒时长、术中体动、术后恶心呕吐比较差异无统计学意义(P> 0.05);LAT组穿刺操作时长较LSC、Ⅱ组更短(P <0.05);三组患儿在术后2
4
24 h CHEOPS评分比较差异无统计学意义(P> 0.05)
术后6 h
CHEOPS评分达高值
LAT组低于LSC、Ⅱ组
差异有统计学意义(P <0.05)
术后12 h
CHEOPS评分逐渐降低
LAT、LSC组低于Ⅱ组
差异有统计学意义(P <0.05)。结论:超声引导不同入路TAP阻滞镇痛时长不一
其中LAT入路操作更快捷、术后镇痛时间更长。
Objective:To investigate the effects of ultrasound-guided transversus abdominis plane(TAP)block using different approaches in inguinal hernia surgery in children and to provide a reference for TAP block in children.Methods:Ninety pediatric patients who were scheduled to undergo inguinal hernia surgery were divided into three groups
with 30 cases in each group:LAT group(via the lateral approach of the anterior axillary line)
LSC group(via the approach connecting the inferior costal margin to the anterior superior iliac spine)
and Ⅱ group(via the inferior and interior approach of the anterior superior iliac spine).The cases were evaluated for the following indices:narcotic dosage
operation duration
time to regaining consciousness
ultrasound guiding duration
intraoperative body motion
postoperative nausea and vomiting
and Children’s Hospital of Eastern Ontario Pain Scale(CHEOPS)scores at 2
4
6
12
and 24 hours after operation.Results:There were no significant differences between the three groups in the dosage of ropivacaine
sufentanil
and propofol as well as operation duration
time to regaining consciousness
intraoperative body motion
and postoperative nausea and vomiting(all P > 0.05).The ultrasound guiding duration in the LAT group was significantly shorter than that in the LSC group and the Ⅱ group(P < 0.05).There were no significant differences between the three groups in CHEOPS scores at 2
4
and 24 hours after operation(P > 0.05).The CHEOPS score peaked at 6 hours after operation
with a significantly lower value in the LAT group than in the LSC group and the Ⅱ group(P < 0.05).The CHEOPS score gradually decreased at 12 hours after operation
with a significantly lower value in the LAT group and the LSC group than in the Ⅱ group(P < 0.05).Conclusion:Ultrasound-guided TAP blocks using different approaches have different analgesic durations
with the LAT approach being more convenient in operation and achieving a longer analgesic duration.
腹横肌平面阻滞超声引导腹股沟疝
Transversus abdominis plane blockUltrasound-guidedInguinal hernia
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