腹横筋膜平面阻滞与腹横肌平面阻滞对腹腔镜子宫切除术患者术后镇痛及早期康复的影响
| 作者: |
1王君灵,
1蔡弥松,
1张作锋
1 海口市第四人民医院麻醉科，海口 571199 |
| 通讯: |
王君灵
Email: 252544744@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.12.019 |
| 基金: | 海南省卫生健康行业科研项目(20A200025)。 |
摘要
Effect of transversalis fascia plane block and transverse abdominal plane block on postoperative analgesia and early rehabilitation in patients undergoing laparoscopic hysterectomy
CorrespondingAuthor: WANG Junling Email: 252544744@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.12.019
Foundation: This work was supported by the Scientific Research Project of Health Industry in Hainan Province, China (20A200025).
Abstract
Objective: To investigate the effects of transversalis fascia plane block (TFPB) and transverse abdominal plane block (TAPB) on postoperative analgesia and early rehabilitation of patients undergoing laparoscopic hysterectomy. Methods: A total of 100 patients undergoing laparoscopic hysterectomy were randomly divided into a TFPB group (n=50) and a TAPB group (n=50). Ultrasound-guided nerve block was performed in both groups. Bilateral TFPB was performed in the TFPB group and bilateral TAPB was performed in the TAPB group. Each side was injected with 0.375% ropivacaine 20 mL. In addition, patient-controlled intravenous analgesia (PCIA) was performed in both groups after the operation. The Visual Analogue Scale (VAS) at 6, 12, 24, and 48 h after the operation was recorded in the 2 groups. The postoperative analgesia and adverse reactions within 48 h after the operation were recorded in the 2 groups. The Pittsburgh Sleep Quality Index (PSQI) score was used to evaluate the sleep quality of patients 1 day before the operation and 1 day after the operation, and 40-item Quality of Recovery (QoR-40) scores was used to evaluate the postoperative recovery quality of patients. Serum interleukin-6 (IL-6) and IL-8 were measured. Results: At 6, 12, 24, 48 h after the operation, the VAS scores of the TFPB group were significantly lower than those of the TAPB group (all P<0.05). The sufentanil dosage and rescue analgesia rate at 24 and 48 h after operation in the TFPB group were significantly lower than those in the TAPB group (both P<0.05), and the analgesic satisfaction score was significantly higher than that in the TAPB group (P<0.05), and the incidence of postoperative nausea and vomiting was significantly lower than that in the TAPB group (P<0.05). At 1 day after operation, the PSQI score of the TFPB group was significantly lower than that of the TAPB group (P<0.05), the QoR-40 score was significantly higher than that of the TAPB group (P<0.05), and serum IL-6 and IL-8 levels in the TFPB group were significantly lower than those in the TAPB group (both P<0.05). Conclusion: TFPB can reduce opioids after laparoscopic hysterectomy, reduce postoperative nausea and vomiting, relieve postoperative stress, and improve the quality of postoperative recovery. The analgesic effect is better than TAPB.