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超声引导下左侧腹横肌平面阻滞联合腹直肌鞘阻滞在腹膜透析置管术中的应用。

Ultrasound-guided left lateral transversus abdominis plane block combined with rectus sheath block in peritoneal dialysis catheter placement.

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui Province, People's Republic of China.

Department of Anesthesiology, The First College of Clinical Medicine, Anhui Medical University, Hefei, 230022, Anhui Province, People's Republic of China.

出版信息

J Anesth. 2018 Aug;32(4):645-648. doi: 10.1007/s00540-018-2528-2. Epub 2018 Jul 5.

Abstract

This study assessed the utility of ultrasound-guided lateral transversus abdominis plane (TAP) block combined with rectus sheath (RS) block for peritoneal dialysis catheter placement surgery. Thirty consecutive patients with end-stage renal disease scheduled to have peritoneal dialysis catheter placement received a left lateral TAP block combined with RS block performed under ultrasound guidance. The TAP and RS blocks were, respectively, conducted with 15 ml of 0.5% ropivacaine and 10 ml of 0.5% ropivacaine. Pain intensity was evaluated by verbal rating scale during operation, and the degree of patient and surgeon satisfaction was qualified by a categorical scale. Twenty-nine patients received successful blocks without any other adjuvant anesthetic drugs. One patient required rescue analgesia with lidocaine infiltration. No complications related to regional anesthesia were noted. Ultrasound-guided left lateral TAP block combined with RS block can serve as the primary anesthetic modality for peritoneal dialysis catheter placement surgery.

摘要

本研究评估了超声引导下侧腹壁横向平面(TAP)阻滞联合腹直肌鞘(RS)阻滞在腹膜透析导管放置手术中的应用。连续 30 例终末期肾病患者接受了腹膜透析导管放置术,在超声引导下进行了左侧 TAP 阻滞联合 RS 阻滞。TAP 和 RS 阻滞分别采用 15ml0.5%罗哌卡因和 10ml0.5%罗哌卡因。术中采用口述评分法评估疼痛强度,采用分类评分法对患者和术者的满意度进行定性评估。29 例患者成功进行了阻滞,无需其他辅助麻醉药物。1 例患者需要利多卡因浸润进行解救性镇痛。未观察到与区域麻醉相关的并发症。超声引导下左侧 TAP 阻滞联合 RS 阻滞可作为腹膜透析导管放置手术的主要麻醉方式。

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