不同浓度罗哌卡因腹横肌平面阻滞用于剖宫产术后镇痛的效果  

Different concentrations of ropivacaine transversus abdominis plane block after cesarean section analgesia

作　　者：许福生[1] 庄海滨[1] 邓莎[1] 刘金花[1] 查本俊[1] 吴志云[1] 

机构地区：[1]中国人民解放军第180医院麻醉科,福建省泉州市362000

出　　处：《临床麻醉学杂志》2014年第10期1012-1014,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨不同浓度罗哌卡因腹横肌平面(transversus abdominis plane,TAP)阻滞用于剖宫产术后镇痛的效果。方法选择ASAⅠ或Ⅱ级剖宫产产妇150例,随机均分为三组:A组、B组和C组术后双侧TAP分别注射0.25%、0.20%、0.15%罗哌卡因1.5mg/kg,并使用PCIA。观察和记录术后4、8、12、24和48h产妇VAS评分。并记录产妇镇痛满意率、镇痛泵按压次数及发生TAP相关并发症(穿破腹膜入腹腔、腹壁严重损伤、感染出血、局麻药误入血管及局麻药中毒)。结果与C组比较,术后不同时点A组产妇VAS评分明显降低(P<0.05)。术后不同时点A组和B组VAS评分差异无统计学意义。与C组比较,A组和B两组产妇对镇痛满意率明显增加、镇痛泵按压次数明显减少(P<0.05)。三组产妇未发生穿破腹膜入腹腔、腹壁严重损伤、感染出血、局麻药误入血管及局麻药中毒等TAP相关并发症。结论 0.20%以上罗哌卡因TAP阻滞联合PCIA用于剖宫产术后镇痛是安全有效的。Objective To observe the minimum effective and safe concentration of ropivacaine（Naropin）in analgesia after cesarean section with transversus abdominis plane block.Methods One hundred and fifty parturient women undergoing cesarean sections were randomly divided into group A,B and C.Bilateral TAP was completed with 0.25%,0.20%,0.15%ropivacaine（Naropin）in 1.5mg/kg after the surgery respectively.All parturient women received patient-controlled intravenous analgesia.Visual analog pain score（VAS）,pump pressing times and analgesia satisfaction at 4,8,12,24 and 48hafter operation were compared.Results Compared with group C,VAS score in group A was lower（P〈0.05）.There was no significance in VAS score between group A and group B at different time point.Compared with group C,analgesia satisfaction increased but pressing times decreased in group A and group B（P〈0.05）.There was no TAP complication in all groups.Conclusion Transversus abdominis plane block with ropivacaine at a concentration of 0.20%is effective and safe in analgesia after cesarean section.

关 键 词：罗哌卡因 腹横肌平面阻滞 镇痛 

分 类 号：R614[医药卫生—麻醉学]