[1]雷碧波,樊 飞,张明强,等.超声引导下腹横肌平面阻滞联合喉罩通气在原发性肝癌患者加速康复外科中的有效性和安全性[J].介入放射学杂志,2023,32(02):149-153.
 LEI Bibo,FAN Fei,ZHANG Mingqiang,et al.The effectiveness and safety of ultrasound-guided transversus abdominis plane block combined with laryngeal mask ventilation general anesthesia in enhanced recovery after surgery for patients with primary liver cancer[J].journal interventional radiology,2023,32(02):149-153.
点击复制

超声引导下腹横肌平面阻滞联合喉罩通气在原发性肝癌患者加速康复外科中的有效性和安全性()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年02
页码:
149-153
栏目:
临床研究
出版日期:
2023-03-03

文章信息/Info

Title:
The effectiveness and safety of ultrasound-guided transversus abdominis plane block combined with laryngeal mask ventilation general anesthesia in enhanced recovery after surgery for patients with primary liver cancer
作者:
雷碧波 樊 飞 张明强 王小琦
Author(s):
LEI Bibo FAN Fei ZHANG Mingqiang WANG Xiaoqi.
Department of Anesthesiology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province 610072, China
关键词:
【关键词】 腹横肌平面阻滞喉罩通气原发性肝癌加速康复外科有效性安全性
文献标志码:
A
摘要:
【摘要】 目的 探计超声引导下腹横肌平面(TAP)阻滞联合喉罩通气在原发性肝癌患者加速康复外科中的有效性和安全性。方法 选择2018年6月至2020年11月成都中医药大学附属医院行腹腔镜肝切除术治疗的患者189例,根据麻醉方法不同分为观察组96例和对照组93例。观察组行超声引导下TAP阻滞联合全身麻醉喉罩通气,对照组行单纯气管内插管全麻,记录术后总住院时间、术后48 h内的镇痛需求、首次排气时间、麻醉药物及血管活性药物消耗量等术中一般情况。记录麻醉诱导前(T0)、手术开始(T1)、手术结束(T2)和离开手术室时(T3)的血糖和乳酸水平;采用40项恢复质量评分量表( QoR-40)及数字评定量表(NRS)评价两组患者早期恢复质量及手术切口疼痛情况,并记录不良反应情况。结果 观察组术后住院时间、首次下床时间、出血量、术后舒芬太尼消耗量、首次排气时间、输液量、七氟烷、瑞芬太尼、罗库溴铵、多巴酚丁胺与去甲肾上腺素消耗量与对照组相比明显降低(均P<0.05)。观察组T1及T2时血糖水平明显低于对照组,T2及T3时血清乳酸水平明显低于对照组(均P<0.05)。观察组术后2、6、24和48 h时,NRS评分均明显低于对照组(均P<0.05);而术后1 d和3 d时,QoR-40评分均明显高于对照组(均P<0.05)。2组患者均有多种不良反应出现,但发生率差异均无统计学意义(均P>0.05)。结论 超声引导下TAP阻滞联合喉罩通气在原发性肝癌患者围手术期有良好的镇痛效果,安全性高,且可减少术中、术后镇痛药物的使用,有利于快速康复。

参考文献/References:

[1] Tian YL, Cao SG, Liu XD, et al. Short- and long-term outcomes associated with enhanced recovery after surgery protocol vs conventional management in patients undergoing laparoscopic gastrectomy[J]. World J Gastroenterol, 2020, 26: 5646-5660.
[2] Hughes MA, Culpin E, Darley R, et al. Enhanced recovery and accelerated discharge after endoscopic transsphenoidal pituitary surgery: safety, patient feedback, and cost implications[J]. Acta Neurochir (Wien), 2020, 162: 1281-1286.
[3] Beano H, Worrilow WM, Robinson M, et al. Safety of surgeon administered transvs abdominis plane(TAP)block after radical cystectomy in the enhanced recovery after surgery(ERAS)era[J]. J Am Coll Surg, 2020, 231: e258-e262.
[4] 魏 晋,于 玲,谭宏宇. 术中麻醉管理对肝癌患者术后丙氨酸转氨酶恢复的影响[J]. 天津医药,2020,48:650-653.
[5] Hong KY, Kim DK, Park HJ, et al. Analgesic efficacy of preemptive transversus abdominis plane block in patients undergoing laparoscopic colorectal cancer surgery[J]. J Clin Med, 2020, 9: 1577-1579.
[6] Womack AS, Smith RB, Hu C, et al. A retrospective study on the impact of transversus abdominis plane block on pain management after laparoscopic hysterectomy[J]. J Minim Invasive Gynecol, 2020, 27: S69-S71.
[7] Jayalekshmi S, Paul C, Thomas M. Efficacy of baska mask and laryngeal mask airway supreme during positive pressure ventilation: a comparative study[J]. J Anaesthesiol Clin Pharmacol, 2020, 36: 31-36.
[8] Muchtar A, Kartika V, Ding D, et al. Comprehensive prevention of hepatitis B virus transmission to reduce primary liver cancer[J]. Shimane J Med Sci, 2020, 37: 13- 20.
[9] Zhang JZ, Ma YZ, Gu JL, et al. Clinical research progress of immune checkpoint inhibitors in treatment of primary liver cancer[J]. World Chinese J Dig, 2020, 28:605-616.
[10] Strathearn LS, Stepanov AI, Font-Burgada J. Inflammation in primary and metastatic liver tumorigenesis-under the influence of alcohol and high-fat diets[J]. Nutrients, 2020, 12: 933-936.
[11] Grant MC, Sommer PM, He C, et al. Preserved analgesia with reduction in opioids through the use of an acute pain protocol in enhanced recovery after surgery for open hepatectomy[J]. Reg Anesth Pain Med, 2017, 42: 451-457.
[12] Dehghan-Tezerjani M, Minagar M, Khan ZH. A standard reversed Y-piece technique for fixation of the laryngeal mask airway[J]. Archives Anesth Critical Care, 2020, 6: 53-54.
[13] Okrainec A, Aarts M, Conn LG, et al. Compliance with urinary catheter removal guidelines leads to improved outcome in enhanced recovery after surgery patients[J]. J Gastrointest Surg, 2017, 21: 1309-1317.
[14] Powell AC, Stopfkuchen-Evans M, Urman RD, et al. Decreasing the surgical stress response and an initial experience from the enhanced recovery after surgery colorectal surgery program at an academic institution[J]. Int Anesthesiol Clin, 2017, 55: 163-178.
[15] Pirzada MT, Naseer F, Haider R, et al. Enhanced recovery after surgery (ERAS) protocol in stoma reversals[J]. J Pak Med Assoc, 2017, 67: 1674-1678.
[16] Jarrar A, Budiansky A, Eipe N, et al. Randomised, double-blinded, placebo-controlled trial to investigate the role of laparoscopic transversus abdominis plane block in gastric bypass surgery: a study protocol[J]. BMJ Open, 2020, 10: e025818.
[17] 单玉兰,周晓林,徐小青. 超声引导髂筋膜阻滞与股神经阻滞治疗全膝关节置换后疼痛的疗效比较[J]. 介入放射学杂志,2020,29:1244-1248.

备注/Memo

备注/Memo:
(收稿日期:2021-12-09)
(本文编辑:新 宇)
更新日期/Last Update: 2023-03-03