Rectus sheath block in peritoneal dialysis catheter implantation / 临床麻醉学杂志

ABSTRACT

Objective To observe anesthetic effects of ultrasound-guided rectus sheath block (RSB)in peritoneal dialysis catheter implantation in patients with end-stage renal disease. Methods A total of 75 uremic patients (38 males,37 females,aged 18-65 years,BMI 18.5-24 kg/m2,ASA physical status Ⅲ),scheduled for elective peritoneal dialysis catheterization,were randomly divided into three groups (n=25 each)using a random number tablegroup Atotal intra-venous anesthesia;group Brectus sheath block,0.5% ropivacaine 15 ml were injected into the lat-eral rectus sheath;group Clocal infiltration anesthesia was performed with 1% lidocaine and 0.5% ropivacaine.The mean arterial pressure and heart rate at the point of entering the operating room (T0),10 min after anesthesia induction (T1),at the beginning of operation (T2),20 min after the beginning of operation(T3),and at the end of the operation(T4)were recorded.The VAS score and Ramsay score at 2,4,8,12,24 h after surgery were recorded.The duration of operation and the oc-currence of adverse reactions were recorded.Results In group A,compared with T0,MAP and HR at T1-T3decreased significantly (P<0.05).In group B,there were no difference among T0-T4.In group C,compared with T0,T1and T4,MAP and HR at T2,T3increased significantly(P<0.05). Compared with group C,the duration of operation time in group A and group B decreased significantly (P<0.05).Compared with group A and group C,the VAS score at each point of group B was lower (P<0.05).Compared with group B,the total number of remediation analgesia in group C increased significantly(P<0.05).There was no adverse reaction in all three groups.Conclusion Ultra-sound-guided rectus sheath block anesthesia is safe and effective in peritoneal dialysis catheter implanta-tion patients with end-stage renal disease,and is worthy of clinical promotion.