Effects of ultrasound-guided transveses abdominis plane block on anesthesia and early postoperative patient-controlled analgesia in patients undergoing gynecological laparoscopic surgery / 中国基层医药

ABSTRACT

Objective To investigate the efficacy of ultrasound-guided transveses abdominis plane block ( TAP) on anesthesia and postoperative analgesia in patients undergoing gynecological laparoscopic surgery. Methods From January 2015 to July 2017,60 patients aged 46 -68 yeas,of American Society of Anesthesiologists (ASA) physical status I-II,scheduled for elective gynecological laparoscopic surgery in Nanxiang Hospital of Jiading District of Shanghai were randomly divided into control group( A group) and ultrasound-guided TAP group( B group) ,with 30 cases in each group,In B group,ultrasound-guided TAP was performed 30 min before induction of anesthesia. The patients in both two groups received patient-controlled intravenous analgesia ( PCIA) for 48 h started from 10 min before the end of surgery. The VAS score ≥4points,sufentanil 5μg was injected intravenously. The consumption of anesthesia drugs during operation,time of consciousness and extubation,the consumption of sufentanil per hour in 24h after operation,requirement for rescue medication,and the adverse reactions within 24h after surgery were also recor-ded. Results Compared with those in A group,the consumption of propofol[(210 ± 32) mg vs. (324 ± 45) mg], sufentanil[(31 ± 3. 6)μg vs. (42 ± 3. 8)μg] in operation and consumption of sufentanil per hour in 24h after operation [(3.2±0.5)μgvs.(5.4±0.7)μg?inBgroupweresignificantlylower(P<0.001).Thetimeofconsciousness [(12 ± 3)min vs. (20 ± 5)min]and extubation[(15 ± 4)min vs. (25 ± 7)min]were significantly reduced in B group (P<0. 001). The requirement for rescue medication(13％ vs. 40％) and the incidence rate of nausea(10％ vs. 33％) and vomiting(0％ vs. 10％) within 24h after surgery were significantly decreased in B group compared with those in A group (P<0. 05). Conclusion Ultrasound-guided TAP performed in patients undergoing gynecologicallaparoscopic surgery can reduce the consumption of anesthesia drugs in operation and optimize postoperative analgesia.