Objective To evaluate whether preoperative Transversus Abdominis Plane (TAP) blockade could decrease the postoperative hyperalgesia in patients undergoing total abdominal hysterecto‐my . Methods Sixty women undergoing total abdominal hysterectomy were randomized toundergo TAP block with ropivacaine (Group TAP) versusnormal saline (Group C) . Group TAP received bilateral ,ul‐trasound‐guided TAP block with 0 .5% ropivacaine ,20 mL at each side and Group C received ultrasound localization of the TAP with injection of normal saline . Maintenance of anesthesia with propofol at 2~3 mg · kg -1 · h-1 and remifentanil ,doses adjusted depending on the hemodynamic changes and bispec‐tral index value . The mechanical pain threshold and the extent of hyperalgesia around the incision were detected and the analgesic consumption and related adverse events were also recorded . Results Com‐pared with Group C ,the mechanical pain thresholds around the incision were obviously higher (P<0 .05) and the extent of hyperalgesia was lower (P<0 .05) in Group TAP at 24 hours and 48 hours after surgery . Group TAP had a longer time to first request for analgesia (P<0 .001) and reduced overall sufentanil consumption (P< 0 .001) when compared with Group C . Conclusion Preoperative ultrasound‐guided TAP blockade with 0 .5% ropivacaine can decrease the postoperative hyperalgesia and provide superior postoperative analgesiain patients undergoing total abdominal hysterectomy .%目的：观察腹横肌平面阻滞对经腹部切口全子宫切除术后痛觉过敏的影响。方法收集择期经下腹部横切口行全子宫切除术患者60例，随机分为腹横肌平面阻滞组（TAP组）和对照组。TAP组患者在麻醉诱导后于超声引导下用0．5％罗哌卡因行双侧腹横肌平面阻滞，每侧20 mL ；对照组患者则用等体积的生理盐水。麻醉维持均采用静脉泵入丙泊酚3～4 mg · kg－1· min－1、瑞芬太尼0．1～0．3μg · kg－1· min－1，并根据脑电双频指数（BIS ）值和血流动力学情况调整麻醉用药。观察患者手术前后切口周围机械痛阈变化及术后痛觉过敏的程度；观察术后静态和动态VAS评分、舒芬太尼消耗量及相关并发症。结果术后24和48 h ，对照组患者切口周围机械痛阈明显低于TAP组（P＜0．05），而TAP组患者切口周围皮肤痛觉过敏程度明显低于对照组（P＜0．05）；TAP组患者术后首次镇痛泵按压时间较对照组明显延迟（ P＜0．001），且舒芬太尼消耗量明显低于对照组（ P＜0．001）。结论术前使用0．5％罗哌卡因行腹横肌平面阻滞可减轻全子宫切除术后痛觉过敏的程度，并提供良好的术后镇痛。
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