|Table of Contents|

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.

References:

-

Memo

Memo:
-
Last Update: 2020-06-02