张伯康, 陈兰仁. 羟考酮联合罗哌卡因腹横筋膜平面阻滞对腹部手术术后快速康复的效果观察[J]. 蚌埠医科大学学报, 2020, 45(8): 997-1000. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.002
    引用本文: 张伯康, 陈兰仁. 羟考酮联合罗哌卡因腹横筋膜平面阻滞对腹部手术术后快速康复的效果观察[J]. 蚌埠医科大学学报, 2020, 45(8): 997-1000. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.002
    ZHANG Bo-kang, CHEN Lan-ren. Effect of oxycodone combined with ropivacaine in the transverse abdominal fascia plane block on the ehanced recovery after surgery after abdominal surgery[J]. Journal of Bengbu Medical University, 2020, 45(8): 997-1000. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.002
    Citation: ZHANG Bo-kang, CHEN Lan-ren. Effect of oxycodone combined with ropivacaine in the transverse abdominal fascia plane block on the ehanced recovery after surgery after abdominal surgery[J]. Journal of Bengbu Medical University, 2020, 45(8): 997-1000. DOI: 10.13898/j.cnki.issn.1000-2200.2020.08.002

    羟考酮联合罗哌卡因腹横筋膜平面阻滞对腹部手术术后快速康复的效果观察

    Effect of oxycodone combined with ropivacaine in the transverse abdominal fascia plane block on the ehanced recovery after surgery after abdominal surgery

    • 摘要:
      目的探究羟考酮联合罗哌卡因腹横筋膜平面阻滞(TAPB)对腹部手术术后快速康复的效果观察。
      方法选取腹部胃肠肿瘤病人90例作为研究对象,所有病人均行开放性手术操作,年龄35~69岁,体质量指数 < 30 kg/m2,ASA分级Ⅰ~Ⅱ级,采用随机数字表法分为2组,各45例。对照组给予羟考酮静脉应用联合罗哌卡因切口浸润,观察组给予羟考酮静脉应用联合TAPB。记录2组病人出手术室时、术后6 h、术后12 h以及术后24 h的疼痛评分、镇静评分、术后并发症、肛门排气时间、首次进食时间和下床活动时间及住院时间。
      结果观察组术后6 h、12 h的静息与术后6 h、12 h和24 h的运动VAS评分明显低于对照组(P < 0.01);观察组术后各时间段镇静评分与对照组相比无明显差异(P>0.05);观察组术后肛门排气时间、首次进食水时间及下床活动时间明显短于对照组(P < 0.01);观察组的术后麻醉相关并发症发生率小于对照组,但差异无统计学意义(P>0.05)。
      结论羟考酮联合TAPB可提高病人术后镇痛效果,对病人胃肠功能的改善具有一定价值,同时能降低病人术后并发症的发生率,加速病人的术后康复,可供临床参考。

       

      Abstract:
      ObjectiveTo investigate the effects of oxycodone combined with ropivacaine in the transverse abdominal fascia plane block(TAPB) on the enhanced recovery after abdominal surgery.
      MethodsNinety patients with abdominal gastrointestinal tumors, aged 35 to 69 years, body mass index < 30 kg/m2 and ASA grade Ⅰ to Ⅱ, were treated with open surgery, and the patients were divided into the observation group and control group(45 cases in each group).The control group was treated with oxycodone intravenously combined with ropivacaine incision, and the observation group was treated with oxycodone intravenously combined with TAPB.The pain scores, sedation scores, postoperative complications, anal exhaustion time, first feeding time, getting out of bed time and length of hospital stay was recorded in two groups at the time of leaving operating room, and postoperative 6 h, 12 h and 24 h.
      ResultsThe VAS scores of the resting after 6 h and 12 h of operation and exercise after 6 h, 12 h and 24 h of operation in observation group were significantly lower than those in control group(P < 0.01).The differences of the sedation scores at each time-point between two groups were not statistically significant(P>0.05).The anal exhaust time, first drinking water time and get out of bed time in observation group were significantly shorter than those in control group(P < 0.01).The incidence rate of postoperative anesthesia-related complications in observation group was few compared with that in control group, but the difference of which was not statistically significant(P>0.05).
      ConclusionsThe oxycodone combined with TAPB can improve the postoperative analgesic effects and improve the gastrointestinal function, reduce the incidence rate of postoperative complications and accelerate the postoperative recovery of patients.

       

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