腹横筋膜平面阻滞与椎旁神经阻滞用于妇科腹腔镜手术患者术后镇痛的效果及安全性比较

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Comparison the effect and safety TAPB and PVB for postoperative analgesia in gynecologic laparoscopicsurgery patientsPeng Tong. ）， ，

【Abstract】ObjectiveTo investigate the eficacy and safety abdominal transverse fascial plane block （TAPB）andparavertebral nerve block （PVB） in postoperative analgesia ingynecological laparoscopic surgery. MethodsA total 136 gynaecological laparoscopic surgery patients admitted to our hospital from September 2021 to October 2O23 were randomly divided into a PVB group anda TAPB group by stratified randomized grouping method，with 68cases ineach group.ThePVB group wasused for analgesia，and the TAPB group wasused for analgesia.Theonset time theblock，duration theblock，patient-controlled intravenousanalgesia （PCIA） compression times，sedation degree [Ramsaysedationscore]，pain degree [visual analogue score （VAS）]andadverse reactions were observed in the PVB group and TAPB group.ResultsThe duration block in the TAPB group was significantly higher than thatthePVB group，andthefrequencyPCIAcompressionand the incidence adverse reactions were lower than that the PVB group，the differences were statistically significant （ P <0.05）.Ramsay in the TAPB group was higher than the PVB group and VAS was lower than the PVB group at 3 h，24 hand 48 h after surgery，the difference was statistically significant （ P <0.05）.There was no significant difference in the onset time the block between the TAPB group and the PVB group（ P>0.05） .ConclusionCompared with PVB，the application TAPB can prolong the duration postoperative block in gynecologic laparoscopic surgery patients，reduce the frequency theuse analgesic drugs in patients，significantlyreduce the degree pain in postoperative patients and avoid the occurrence adverse reactions，and the analgesic efect and safety are both good.

【Key Words】Transverse fascial plane block;Analgesic efect;Gynecological laparoscopic surgery; Paravertebral nerve block；Adverse reaction

腹腔镜手术因具有恢复迅速、创伤微小的优势，在妇科疾病的临床治疗中得到广泛应用，在妇科腹腔镜手术过程中，选用恰当的镇痛方式至关重要，不仅有助于手术的顺利进行，还能有效减少麻醉药物的使用量，进而减轻患者术后的不良反应，提升术后的镇痛效果[1，2]。（剩余6203字）