The clinical effect of multimodal analgesia by transversus abdominis plane block combined with patient controlled intervenous analgesia in postoperative patients with splenectomy based on enhanced recovery after surgery theory
10.3969/j.issn.1008-9691.2023.06.012
- VernacularTitle:基于ERAS理念TAPB联合PCIA的多模式镇痛在脾切除患者术后镇痛中的临床效果
- Author:
Yunfei DU
1
,
2
;
Shaojun XIONG
;
Wei MAO
Author Information
1. 南昌市第九医院普外科,江西南昌 330002
2. 赣北医院麻醉科,江西九江 332002
- Keywords:
Transversus abdominis plane block;
Patient controlled intravenous analgesia;
Visual analogue scale;
Splenectomy
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2023;30(6):697-700
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effect of transversus abdominis plane block(TAPB)combined with patients controlled intravenous analgesia(PCIA)on the analgesia of patients after splenectomy.Methods A retrospective study method was conducted.A total of 63 patients who underwent splenectomy+pericardial vascular dissection in the department of general surgery of Nanchang No.9 Hospital from January to December 2021 were selected as the study objects.The patients were divided into TAPB combined with PCIA group(33 cases)and alone PICA group(30 cases)according to different postoperative analgesia techniques,and the postoperative analgesia effect was compared between the two groups.Results There was no significant difference between the two groups in sex,age,height,body mass,Child-Pugh grade and American Society of Anesthesiologists(ASA)grade.The operation time,intraoperative blood loss and intraoperative blood transfusion volume in TAPB combined with PCIA group were increased compared with alone PICA group[operation time(minutes):85.0(32.5)vs.82.5(40.0),intraoperative blood loss(mL):500(300)vs.425(500),intraoperative blood transfusion(mL):400(300)vs.300(525)],the incidence of postoperative abdominal infection and incisional infection tended to decrease compared with alone PICA group[abdominal infection:18.2％(6/33)vs.20.0％(6/30),incisional infection:21.2％(7/330)vs.23.3％(7/30)],but there was no significant difference between the two groups(both P>0.05).The visual analogue score(VAS)decreased gradually over time in both groups,and VAS in TAPB combined with PCIA group was significantly lower than that in PICA group at 6,12,24,48 and 72 hours after operation[4.0(1.0)vs.6.0(3.0),3.0(2.0)vs.4.0(2.0),2.0(1.5)vs 3.5(1.5),1.0(1.0)vs.2.0(1.5),1.0(1.0)vs.2.0(2.0),all P<0.05],the total number of PCIA compressions in TAPB combined with PCIA group was significantly lower than that of alone PICA group(times:2.64±1.19 vs.3.67±1.67,P<0.05).Conclusion The analgesic effect of TAPB combined with PCIA after splenectomy and devascularization is better than that of PCIA alone.
