临床普外科电子杂志 ›› 2022, Vol. 10 ›› Issue (3): 145-.

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超声引导下神经阻滞应用于腹腔镜胆囊切除术中对患者疼痛的影响

  

  1. 绵阳四○四医院 疼痛科,四川 绵阳 621000
  • 出版日期:2022-07-01 发布日期:2022-10-25

Effect of ultrasound-guided nerve block on pain in patients undergoing laparoscopic cholecystectomy

  1. Pain Department of Mianyang 404 Hospital, Sichuan Mianyang 621000, China
  • Online:2022-07-01 Published:2022-10-25

摘要:

目的 探讨超声引导下神经阻滞在腹腔镜胆囊切除术中的应用效果及对患者术后疼痛的影响。方法 选取2020 年1 月至2021 年10 月在绵阳四○四医院接受腹腔镜胆囊切除术治疗的62 例患者进行研究,经随机数字表法分为对照组(31 例,实施戳孔局部浸润镇痛)和观察组(31 例,实施超声引导下神经阻滞麻醉镇痛)。分析两组患者临床指标、术后不同时间疼痛程度与不良反应发生情况。结果 观察组患者苏醒时间短于对照组;追加镇痛药物剂量、追加频次少于对照组,差异有显著性(P < 0.05)。观察组患者术后清醒时、6h、24h、48h 视觉模拟评分法(visual analogue scale,VAS)评分均低于对照组,差异有显著性(P< 0.05)。对照组、观察组术后不良反应发生率各为6.45%、12.90%,差异无显著性(P > 0.05)。结论 超声引导下神经阻滞应用于腹腔镜胆囊切除术患者,不仅能够缩短患者术后苏醒时间,减少镇痛药物的使用剂量与次数,而且患者术后疼痛程度轻。

关键词: 超声, 神经阻滞, 腹腔镜胆囊切除术, 疼痛

Abstract:

Objective To investigate the effect of ultrasound-guided nerve block in laparoscopic cholecystectomy and its effect on postoperative pain. Method 62 patients who underwent laparoscopic cholecystectomy in Mianyang 404 Hospital from January 2020 to October 2021 were randomly divided into control group (31 cases, local infiltration analgesia) and observation group (31 cases, nerve block anesthesia and analgesia under ultrasound guidance). The clinical indexes, postoperative pain degree and adverse reactions of the two groups were analyzed. Result The recovery time of patients in the observation group was shorter than that in the control group; The dosage and frequency of additional analgesic drugs were less than those in the control group (P < 0.05). The scores of visual analogue scale (VAS) in the observation group were lower than those in the control group at awake, 6h, 24h and 48h after operation (P < 0.05). The incidence of postoperative adverse reactions in the control

group and the observation group were 6.45% and 12.90% respectively, with no significant difference (P > 0.05). Conclusion The application of ultrasound-guided nerve block in patients undergoing laparoscopic cholecystectomy can not only shorten the postoperative recovery time, reduce the dosage and times of analgesic drugs, but also reduce the degree of postoperative pain.

Key words: Ultrasound, Nerve block, Laparoscopic cholecystectomy, Pain