B超引导下腹横肌平面阻滞对腹腔镜下阑尾及疝气术后患者血流动力学及切口疼痛的影响OA

Objective To investigate the effect of B-ultrasound guided transversus abdominis plane block on hemodynamics and incision pain in patients after laparoscopic appendectomy and hernia surgery.Methods Sixty patients who underwent laparoscopic appendectomy and hernia surgery in Shangli County People's Hospital from January 2022 to June 2023 were selected as the research objects.The patients were divided into control group and TAP group by random number table method,with 30 patients in each group.The control group was operated under tracheal intubation anesthesia,and postoperative patient-controlled intravenous analgesia(PCIA)was given.Based on the control group,the TAP group was given B-ultrasound-guided TAP block after anesthesia induction.The clinical indexes(the first time of getting out of bed after operation,the first time of exhaust after operation,the time of hospitalization,the time of operation),hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR)]at different time periods[when entering the operating room(T0),before skin incision(T1),5 min after skin incision(T2),10 min after skin incision(T3)],incision pain[Visual Analogue Scale(VAS),Ramsay sedation score(RSS)]after operation were compared between the two groups.Results Compared with the control group,the first time of getting out of bed after operation,the first time of exhaust after operation and the time of hospitalization in the TAP group were shorter,the MAP and HR at T1,T2 and T3 were lower,and the VAS score and RSS score at 2,4 and 12 h after operation were lower(P＜0.05).There was no significant difference in the operation time between the TAP group and the control group(P＞0.05).Conclusion B-ultrasound guided TAP block can effectively maintain stable vital signs during laparoscopic appendectomy and hernia surgery,reduce postoperative pain and agitation,promote rapid recovery of patients,and have good analgesic effect.