Effect of Ultrasound-guided Transversus Abdominis Plane Block Combined with Spinal Epidural Anesthesia on Postoperative Analgesia and Levels of Serum CRP and IL-6 in Patients with Lower Abdominal Surgery
SHANG Di
The Third People's Hospital of Liaoyang,Liao Ning, 111000 China
Abstract：Objective To analyze the effect of ultrasound-guided transversus abdominis plane block combined with spinal epidural anesthesia on postoperative analgesia, serum CRP and IL-6 Levels in patients undergoing lower abdominal surgery. Methods A total of 80 patients with lower abdominal surgery who were treated in our hospital from January 2016 to August 2017 were selected as the research objects. All patients (ASAⅠor Ⅱ grade) underwent spinal epidural anesthesia. According to random number table method, patients were divided into two groups with 40 cases in each (n=40): the conventional group received patient-controlled intravenous analgesia (PCIA) and the study group received ultrasound guided transversus abdominis plane block +PCIA. The VAS, Ramsay sedation scores, serum C reactive protein (CRP) and interleukin-6 (IL-6) levels were measured at different times after operation and compared between the two groups. Results The VAS scores at the 2, 6 and 24 h after operation in the study group were significantly lower than those in the conventional group, the differences were statistically significant (P<0.05). There was no significant difference in VAS score between the two groups at 48 h after operation (P>0.05). There were no significant differences in Ramsay sedation score between the two groups at different time points after operation (P>0.05). The serum levels of CRP and IL-6 in the study group were significantly lower than those in the conventional group at 6, 24 and 48 h after operation. The differences were statistically significant (P<0.05). The number of pressing pump and sufentanil in the study group 24 h after operation were significantly lower than those in the conventional group, and the differences were statistically significant (P<0.05). Conclusion Ultrasound-guided transversus abdominis plane block improves the analgesic effect and alleviates inflammatory stress response 24 hours post-operation in patients with lower abdominal surgery.
尚荻. 超声引导下腹横肌平面阻滞联合腰-硬麻醉对下腹部手术患者术后疼痛及CRP、IL-6水平影响[J]. 医学临床研究, 2019, 36(2): 243-245.
SHANG Di. Effect of Ultrasound-guided Transversus Abdominis Plane Block Combined with Spinal Epidural Anesthesia on Postoperative Analgesia and Levels of Serum CRP and IL-6 in Patients with Lower Abdominal Surgery. JOURNAL OF CLINICAL RESEARCH, 2019, 36(2): 243-245.
[1] 郭荟楠,郭海云,郭永清.术后镇痛泵的使用[J].中国药物与临床,2013,13(1):40. [2] 余守章.一种术后镇痛的新方法-自控-靶控镇痛[J].广东医学,2009,30(8):1043-1045. [3] Hebbard P,Fujiwara Y,Shibata Y,et al.Ultrasound-guided transversus abdominis plane (TAP) block[J].Anaesth Intensive Care,2007,35(4):616-617. [4] Gasanova I,Grant E,Way M,et al.Ultrasound-guided transversus abdominal plane block with multimodal analgesia for pain management after total abdominal hysterectomy[J].Arch Gynecol Obstet,2013, 288(1):105-111. [5] 徐海军.地佐辛混合不同剂量右美托咪定用于术后镇痛对照研究[J].中国药业,2014,23(21):29-31. [6] 龚继平,孟瑞霞.右美托咪定和地佐辛联合术后自控静脉镇痛研究[J].中国实用医药,2013,8(17):5-8. [7] 王玥,刘洁,侯丽娜,等.患者静脉自控镇痛与患者硬膜外自控镇痛的比较[J].现代生物医学进展,2015,15(10):1979-1983. [8] Kim NY,Kwon TD,Bai SJ,et al.Effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia on pain attenuation after open gastrectomy in comparison with conventional thoracic epidural and fentanyl-based intravenous patient-controlled analgesia[J].Int J Med Sci,2017,14(10):951-960. [9] Rafi AN.Abdominal field block: a new approach via the lumbar triangle[J].Anaesthesia,2001 56(10):1024-1026. [10] 何建华,马曙亮,顾连兵,等.超声引导腹横肌平面阻滞在结直肠癌手术中的应用[J].临床麻醉学杂志,2010,26(12):1070-1072. [11] 王琳,徐铭军.超声引导腹横肌平面阻滞对妇科腹腔镜手术后镇痛的影响[J].临床麻醉学杂志,2013,29(11):1057-1059. [12] 蒋洪宇,熊继君,张玲,等.超声引导下腹横肌平面阻滞复合全麻对下腹部手术患者应激反应和术后恢复的影响[J].中国医师杂志,2017,19(2):275-276. [13] 冯舒韵,杨承祥,张文璇,等.超声引导下腹横肌平面阻滞在妇科腹腔镜手术后镇痛及炎性因子的研究[J].检验医学与临床,2016,13(3):309-311. [14] Hsiao CC,Chang CH,Fan PC,et al.Prognosis of patients with acute respiratory distress syndrome on extracorporeal membrane oxygenation: the impact of urine output on mortality[J].Ann Thorac Surg,2014,97(6):1939-1944. [15] 徐涛,马颖璋,杨廷松,等.腹腔镜手术治疗急性阑尾炎的临床疗效及对血清PCT和CRP水平的影响[J].现代生物医学进展,2016,16(23):4458-4461. [16] Okur O,Tekgul ZT,Erkan N.Comparison of efficacy of transversus abdominis plane block and iliohypogastric/ilioinguinal nerve block for postoperative pain management in patients undergoing inguinal herniorrhaphy with spinal anesthesia: a prospective randomized controlled open-label study[J].J Anesth,2017,31(5):678-685.
2019, Vol. 36 
