【摘要】 目的 分析腹横肌平面阻滞联合无阿片类药物全身麻醉技术对妇科腹腔镜术后恶心呕吐的影响。方法 应用随机数表法将方便选取2021年7月—2022年10月期间广州中医药大学东莞医院收治的行妇科腹腔镜手术的162例患者分为对照组和研究组，每组81例。行单纯静脉全身麻醉的患者纳入对照组，行腹横肌平面阻滞联合无阿片类药物全身麻醉技术的患者纳入研究组，比较两组麻醉效果。结果 研究组术后恶心呕吐发生率（2.50%）低于对照组（12.35%），差异有统计学意义（χ~2=5.760,P<0.05）。研究组术后2、12 h的VAS评分、苏醒时间、拔除气管导管时间优于对照组，切皮、术毕、拔管的心率与血压低于对照组，差异有统计学意义（P<0.05）。结论 妇科腹腔镜手术患者围术期给予腹横肌平面阻滞联合无阿片类药物全身麻醉技术效果理想，不仅可减少芬太尼用量，同时可改善术后早期恢复和镇痛效果，具有较高的可行性。更多还原

【Abstract】 Objective To analyze the effect of transversus abdominis plane block combined with opioid-free general anesthesia on nausea and vomiting after gynecological laparoscopy. Methods By the random number table method,162 patients who underwent gynecological laparoscopic surgery at Dongguan Hospital of Guangzhou University of Traditional Chinese Medicine from July 2021 to October 2022 were conveniently selected divided into a control group and a study group, with 81 patients in each group. Patients undergoing simple intravenous general anesthesia were included in the control group, and patients undergoing transversus abdominis muscle plane block combined with general anesthesia without opiates were included in the study group. The anesthetic effects of the two groups were compared.Results The incidence of postoperative nausea and vomiting in the study group(2.50%) was lower than that in the control group(12.35%), and the difference was statistically significant(χ~2=5.760, P<0.05). The VAS score, recovery time,and tracheal catheter removal time of the study group at 2 h and 12 h after surgery were better than those of the control group, the heart rate and blood pressure of the skin incision, surgery completion, and tracheal catheter removal were lower than those of the control group, and the difference was statistically significant(P<0.05). Conclusion Transversus abdominis plane block combined with opioid-free general anesthesia is ideal for perioperative patients undergoing gynecological laparoscopic surgery. Not only can the dosage of fentanyl be reduced, but also the early postoperative recovery and analgesic effect can be improved, which has high feasibility.更多还原