摘要
目的观察超声引导下腹横肌平面(TAP)阻滞用于小儿腹股沟斜疝手术患儿术中及术后的镇痛效果。方法选择择期行小儿腹股沟斜疝修补术患儿36例,随机分为观察组(A组)和对照组(B组)各18例,入室前开放静脉通路,静脉注射KLS合剂0.15 mL/kg,待患儿入睡后,在超声引导下行TAP阻滞,A组注入0.33%盐酸罗哌卡因1.5 mg/kg,B组注入等量生理盐水。根据术中情况追加KLS合剂。比较两组患儿术中切皮反应、KLS合剂用量及术后CHEOPS评分、Ramesay评分等。结果 A组切皮时平均动脉压和心率的变化明显小于B组(P<0.05),A组术后2、4、8 h的镇痛评分均低于B组(P<0.05),镇痛泵按压次数减少(P<0.05)。两组均未见TAP阻滞穿刺引起的不良反应。结论超声引导下的TAP阻滞用于小儿腹股沟斜疝手术能有效镇痛。
Objective To investigate the intra-and postoperative analgesic effects of ultrasound-guided transverse abdominis plane（TAP） block in pediatric patients undergoing inguinal hernia repair.Methods 36 pediatric patients scheduled for elective inguinal hernia repair were randomly divided into two groups：study group（group A,n=18） or control group（group B,n=18）.Intravenous line was inserted before entering the operating room.KLS mixture 0.15 mL/kg was injected to make the patient sleep.Ultrasound-guided transverses abdominis plane block was performed,and 0.33% ropivacaine hydrochloride 1.5 mg/kg was injected for group A patients.The equal volume of normal saline was used instead for group B patients.KLS mixture was supplemented as needed.The hemodynamic response when incision,the volume of KLS mixture used,CHEOPS scores and Ramesay scores after operation were compared between the two groups.Results Compared to group B,the variation of mean arterial pressure（MAP） and hear rate（HR） when incision was significantly smaller in group A（P〈0.05）.The analgesic scores of group A patients at 2,4,8 h after operation were significantly lower than group B patients（P〈0.05）.The number of PCIA used was reduced in group A（P〈0.05）.No TAP related side effects were observed in both groups.Conclusion Ultrasound-guided TAP block can be effectively used for inguinal hernia repair in pediatric patients.
出处
《医学综述》
2011年第18期2836-2837,共2页
Medical Recapitulate
关键词
超声引导
腹横肌平面阻滞
小儿
镇痛
Ultrasound-guided
Transverse abdominis plane block
Children
Analgesia
