Clinical study on transversus abdominis plane block by "S-Nerve" ultrasound guidance(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2020年第5期
- Page:
- 599-603
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Clinical study on transversus abdominis plane block by "S-Nerve" ultrasound guidance
- Author(s):
- HUANG Qiaowen1; LIN Zhijian1; LU Zhiwei1; LIN Xiaolei2
- 1. Department of Anesthesiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China 2. Department
of General Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China
- Keywords:
- Keywords: S-Nerve type ultrasound-guidance transversus abdominis plane block stress pain cognitive dysfunction
- PACS:
- R614.4
- DOI:
- DOI:10.3969/j.issn.1005-202X.2020.05.013
- Abstract:
- Abstract: Objective To observe the clinical effects of transversus abdominis plane block (TAPB) by "S-Nerve" ultrasound guidance
on elderly patients. Methods Forty elderly patients undergoing laparoscopic radical resection of colorectal cancer were enrolled
and randomly divided into observation group and control group, with 20 cases in each group. The patients in control group were
given total intravenous anesthesia, while those in observation group were given "S-Nerve" ultrasound-guided bilateral TAPB after
general anesthesia induction, with the mixture of 2 mL of 0.5 μg/kg dexmedetomidine and 0.2%of 1 mg/kg ropivacaine each lateral.
The mean arterial pressure (MAP), heart rate (HR) and cortisol level (Cor) before operation (T0), at skin incision (T1), at 30 min
of operation (T2) and immediately tracheal extubation (T3) were compared between two groups. Moreover, intraoperative anesthetic
dosages, the pain visual analogue scale (VAS) scores at 2, 6, 12 and 24 h after operation, the mini-mental state examination (MMSE)
scores at 1 d before operation, at 1 d after operation and at 3 d after operation and the incidence rate of postoperative cognitive
dysfunctions were also compared. Results The success rate of ultrasound-guided one-time puncture was 100% in observation
group.At T1, T2 and T3, the MAP, HR and Cor in observation group were significantly lower than those in control group (P<0.05).
The dosages of intraoperative propofol and remifentanil in observation group were significantly less than those in control group
(P<0.05).At 2, 6 and 12 h after operation, the VAS scores in observation group were significantly lower than those in control group
(P<0.05).At 1 d after operation, the MMSE score in observation group was significantly higher than that in control group (P<0.05),
and the incidence rate of cognitive dysfunctions in observation group was 15%, significantly lower than 45% in control group
(P<0.05). Conclusion For elderly patients undergoing laparoscopic surgery, TAPB guided by "S-Nerve" ultrasound has the
advantages of visualization and accurate positioning, and reduces the risk of blind puncture injuries. Compared with general anesthesia, general anesthesia combined with ultrasound-guided TAPB is more effective in relieving surgical stress responses,
lowering intraoperative anesthetic dosages, reducing postoperative pain and improving postoperative cognitive function.
Last Update: 2020-06-02