【摘要】 目的:观察三种不同入路的腹横肌平面阻滞(TAP)应用于小儿下腹部手术术后镇痛的效果。方法:选择90例下腹部手术的患儿,年龄1~6岁,按照随机数字表法将其分为L、C、H三组,每组30例。L组行全身麻醉+肋缘下TAP,C组行全身麻醉+侧路TAP,H组行全身麻醉+后路TAP。观察并记录术后2、6、12、24 h的CHEOPS疼痛评分、Ramesay评分,以及与术后镇痛相关的不良反应。结果:与术后2 h比较,L组的术后12、24 h及C、H组的术后24 h CHEOPS评分均升高(P<0.05)、Ramesay评分下降(P<0.05);与L组术后12 h比较,C、H组术后12 h CHEOPS评分升高(P<0.05)、Ramesay评分下降(P<0.05)。与H组比较,L组、C组的下肢运动异常的发生率更低(P<0.05)。结论:三种腹横肌平面阻滞均可以有效地缓解小儿下腹部手术术后12 h内的疼痛,肋缘下入路TAP镇痛时间稍短,后路入路TAP有一定的下肢肌力下降。更多还原

【Abstract】 Objective:To observe the effect of three different approaches of transversus abdominis plane(TAP) block in pediatric abdominal surgery postoperative analgesia.Method:A total of 90 children with abdominal operation,aged 1-6 years old,were divided into L,C and H groups according to random number table method,30 cases in each group.L group received general anesthesia + rib edge TAP,C group received general anesthesia + axillary midline TAP,H group received general anesthesia + posterior TAP.CHEOPS pain score,Ramesay score and postoperative analgesia related adverse reactions of three groups were observed and recorded after 2,4,8,12 h. Result:Compared with postoperative 2 h,L group after 8,12 h and C group,H group after 12 h,CHEOPS scores were significantly increased(P<0.05),Ramesay scores decreased(P<0.05).Compared with L group after 12 h,C group and H group after 12 h CHEOPS scores increased(P<0.05),Ramesay scores decreased(P<0.05).Compared with H group,the lower limb motor abnormalities of L group and C group were lower(P<0.05).Conclusion:Three transversus abdominis plane block are effectively relieve pain of children after 12 h of lower abdominal surgery,analgesia time of rib edge TAP is shorter,posterior TAP decreases muscle strength of lower limbs.更多还原