Abstract: Objective To explore the application effects and safety of Laparoscopic-guided rectus sheath block on single-incision laparoscopic cholecystectomy. Methods Retrospective analysis was performed on 100 patients who were undergone single-incision laparoscopic cholecystectomy from October 2019 to March 2021, of whom 50 patients were performed laparoscopic-guided rectus sheath block, and others were performed local infiltration anesthasia. Postoperative pain score, first ambulation, complications was compared between two groups. Visual analogue scale was applied to evaluate the pain on 2 h, 6 h、12 h and 24 h after operation. Results There was no significant difference in gender, age, weight, operating time between two groups. The observation group had lower VAS scores at the time of 2 h,and 6 h,12 h after operation as compared with the control group, respectively（1.7±1.1 vs 3.1±1.1, P<0.001; 1.7±1.2 vs 2.7±0.9, P<1.9±0.8 vs 2.4±0.8,P=0.001）. And there was no significant difference at the time of 24 h （1.7±1.0 vs 1.9±1.2, P=0.411）. And the observation group shows superior advantage on the first ambulation（8.3±1.1 vs 10.7±1.5 h, P<0.001）. There were no complications on both groups. Conclusion Laparoscopic-guided rectus sheath block on single-incision laparoscopic cholecystectomy is effective and safe. It is a method to release the pain after operation which is performed by surgeon easily.

Key words: laparoscopic-guided, rectus sheath block, single-incision laparoscopic cholecystectomy

摘要： 目的 评估腹腔镜辅助腹直肌鞘阻滞在单孔腹腔镜胆囊切除术患者腹壁镇痛的有效性及安全性。方法 选取2019年10月至2021年3月江门市中心医院肝胆胰脾外科行单孔腹腔镜胆囊切除术的100例患者,其中50例患者作为观察组行腹腔镜辅助腹直肌鞘阻滞,50例患者作为对照组行局部浸润麻醉。采用视觉模拟量表（VAS）疼痛评分进行术后2 、6、12、24 h疼痛评分;记录术后患者首次下地活动时间。结果 术后2、6、12 h观察组疼痛明显轻于对照组（1.7±1.1 vs 3.1±1.1,P<0.001;1.7±1.2 vs 2.7±0.9,P<0.001;1.9±0.8 vs 2.4±0.8,P=0.001）,在24 h两者无明显差异（1.7±1.0 vs 1.9±1.2,P=0.411）。术后首次下地时间观察组明显早于对照组（8.3±1.1 vs 10.7±1.5,P<0.001）两组均无并发症。结论 腹腔镜辅助下腹直肌鞘阻滞是一种可由手术医师操作的、安全易行的、有效的围手术期镇痛方式。

关键词: 腹腔镜辅助, 腹直肌鞘阻滞, 单孔腹腔镜胆囊切除术