引用本文:范建龙.超声引导腹横肌平面阻滞联合喉罩全麻在高龄患者腹股沟无张力疝修补术中的效果探讨[J].中国临床新医学,2018,11(9):913-916.
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超声引导腹横肌平面阻滞联合喉罩全麻在高龄患者腹股沟无张力疝修补术中的效果探讨
范建龙
723000 陕西,汉中市铁路中心医院麻醉科
摘要:
[摘要] 目的 探索高龄患者腹股沟张力疝修补术理想的麻醉方式。方法 2015-01~2016-04行高龄患者腹股沟张力疝修补术42例,其中H组单纯喉罩全麻21例,T组超声引导TAP联合喉罩全麻21例,比较两组患者术中不同时间点平均动脉压和心率、术中术后镇痛药用量、拔除喉罩的时间、术后视觉模拟评分(VAS)以及麻醉满意度。结果 与T组比较,H组在T3和T4时间点的平均动脉压和心率的差异有统计学意义(P<0.05)。与T0~T2和T5比较,单纯喉罩全麻在T3和T4时间点的平均动脉压和心率高,差异有统计学意义(P<0.05)。H组术后拔除喉罩的时间长、术后VAS评分高、麻醉满意度低,与T组比较差异有统计学意义(P<0.05)。结论 超声引导下TAP联合喉罩全麻麻醉效果确切,术中术后镇痛效果确切,对患者血流动力学影响较小,且患者满意度较高,是高龄患者行腹股沟张力疝修补术的一种较为理想的麻醉方式。
关键词:  腹横肌  神经阻滞  喉罩  高龄患者  腹股沟张力疝
DOI:10.3969/j.issn.1674-3806.2018.09.18
分类号:R 614
基金项目:
Efficacy of ultrasound-guided transversus abdominis plane block combined with laryngeal mask anesthesia in aged patients undergoing inguinal tension-free hemioplasty
FAN Jian-long
Department of Anesthesiology, Railway Central Hospital of Hanzhong City, Shanxi 723000, China
Abstract:
[Abstract] Objective To explore a satisfactory way of anesthesia for aged patients undergoing inguinal tension-free hemioplasts. Methods Inguinal tension-free hemioplasty was performed on 42 aged patients in our hospital from January 2015 to April 2016. The patients were divided into group H and group T according to different anesthesia methods. Group H(n=21) used laryngeal mask for anesthesia alone, and group T(n=21) used ultrasound-guided transversus abdominis plane block combined with laryngeal mask anesthesia. The blood pressure and heart rate, intraoperative and postoperative analgesic dosages, time to remove laryngeal mask, postoperative visual analogue scale(VAS) and anesthesia satisfaction rate were compared between the two groups at difference time points. Results Compared with those in group T, the blood pressure and heart rate in group H were significantly higher at T3(traction peritoneum) and T4(6 h after surgery)(P<0.05). In group H, compared with those at T0(before anesthesia), T2(after skin incision ) and T5(24 h after surgery), the blood pressure and heart rate were significantly higher at T3(traction peritoneum) and T4(6 h after surgery)(P<0.05). Compared with those in group T, the time to remove laryngeal mask was significantly longer, and the postoperative VAS scores were significantly higher and the satisfactory rate was significantly lower in group H(P<0.05). Conclusion Ultrasound-guided transversus abdominis plane block combined with laryngeal mask is effective in anesthesia for the aged patients undergoing inguinal tension-free hemioplasty.
Key words:  Transversus abdominis plane  Nerve block  Laryngeal mask  Aged patients  Tension-free inguinal hernia