Clinical Research Of Ultrasound-guided Transversus Abdominis Plane Block Combined With Laryngeal Mask General Anesthesia In Peritoneal Dialysis Catheter

Objective:To observe the effect of ultrasound-guided transversus abdominis plane block combined with laryngeal mask general anesthesia for peritoneal dialysis catheter,and the influence of intraoperative hemodynamics,postoperative analgesia score and comfort score,and provide reference for clinical application.Methods:The Department of Nephrology end-stage renal disease or chronic kidney disease in 5,scheduled for general anesthesia in peritoneal dialysis catheter in 60patients,aged 18 to 65 years,ASA III,BMI<30kg/m²;no serious heart brain pulmonary function diseases,no abnormal coagulation function and no puncture site were identified.According to the random number table method,ultrasound-guided transversus abdominis plane block group?group T?and control group?group C?were divided into 2 groups.In both groups,the anterior plane of the lateral abdominis muscle was blocked after induction of anesthesia.In group T,0.33%of ropivacaine was injected into 25 mL.In group C,normal saline was injected.Propofol was administered intravenously to maintain anesthesia and BIS values??were maintained 40 to 60.Record hemodynamic parameters:including SBP,DBP,and HR before surgery?T₀?,before incision?T₁?,2 min?T₂?and 30 min?T₃?;Record the completion time of surgery,intraoperative Sufen Tunisia dosage and infusion volume;postoperative patient-controlled analgesia:including postoperative analgesic pump-controlled analgesia times and calculation of total sufentanil use;recording VAS scores at 2h,6h,12h,24h,and 48h after surgery BCS comfort scores;statistical anesthesia and postoperative complications.Results:1.Compared with group C,SBP,DBP and HR were lower in group T than in group C at time T₂?P<0.05?;SBP and DBP were lower in group T than that in group C at the time of T₃?P<0.05?).2.Compared with group C,VAS scores of group T at 2h,6h and 12h after operation were significantly different?P<0.05?;compared with group C,group T was at time points of 2h,6h,12h and 24h after operation,The BCS score was higher,the difference was statistically significant?P<0.05?,and there was no significant difference in BCS score at 48 hours after operation?P>0.05?.3.The dosage of sufentanil in the two groups was significantly lower in the group T?11.6±1.2?than in the group C?21.4±1.5??P<0.05?.Both groups received intravenous self-control.Analgesia and compression times were significantly lower in the group T?2.8±0.8?than in the group C?7.6±1.0??P<0.05?;the total amount of sufentanil in the group T?113.2±8?was also It was significantly lower than that in group C?132.6±12?.The difference was statistically significant?P<0.05?.4.There were 3 cases of nausea and vomiting after operation in group C and 2cases after operation in group T.There was no significant difference between the two groups?P>0.05?.No puncture hematoma,respiratory depression,visceral injury and urinary retention occurred in the two groups complication.Conclusion:Ultrasound-guided transversus abdominis plane block combined with laryngeal masked general anesthesia for peritoneal dialysis catheterization,better intraoperative anesthesia,more stable hemodynamics,lower postoperative pain scores,higher comfort,anesthesia and puncture concurrent and there are fewer symptoms.