ĐÁNH GIÁ ẢNH HƯỞNG LÊN TUẦN HOÀN, HÔ HẤP VÀ MỘT SỐ TÁC DỤNG KHÔNG MONG MUỐN CỦA GIẢM ĐAU SAU MỔ CẮT TỬ CUNG HOÀN TOÀN ĐƯỜNG BỤNG BẰNG GÂY TÊ MẶT PHẲNG CƠ NGANG BỤNG DƯỚI HƯỚNG DẪN CỦA SIÊU ÂM

Abstract

Objective: To evaluate the effects on circulation, on respiration and some other side effects of Ultrasound guided transversus abdominis plane (TAP) block after total abdominal hysterectomy with ropivacaine 0.25%. Mthods: 60 patients with spinal anesthesia underwent total abdominal hysterectomy were randomly divided in two groups: Treatment group getting ultrasound guided TAP block with 0.75 mg/kg of ropivacaine 0.25% in both sides combined with intravenous morphine PCA at the end of surgery, and control group had not received TAP block for pain relief and used only IV morphine PCA alone (control group). We continuously recorded mean blood pressure, heart rate, respiratory rate, sedation, nausea, vomiting, urinary retention, pruritus… during the surgery and for the first 24 hours after surgery. Results: There was no difference in circulatory and respiratory parameters of patients in the two groups. The rates of nausea and vomiting of the TAP block group were significantly lower than the control group (13.33% versus 30%; p <0.05). The rate of sedation level I and II of the TAP block group was also significantly lower than the control group (30% versus 63.3%). The rates of pruritus and urinary retention did not differ between the two groups (3.3% and 6.7% and 6.7% versus 6.7% and 6.7%). Conclusions: Bilateral untrasound guided TAP block with ropivacaine 0.25%, did not affect on the patient's circulation and respiration but reduced the rate of vomiting, nausea and sedation level I, level II compared with the control group.