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比较  

Clinical Efficacies of Different Doses of Ropivacaine for Post-cesarean Delivery Analgesia Con-trolled by Transversus Abdominis Plane Blockage

作　　者：杨建兵[1] 刘际童[2] 

机构地区：[1]湖南省长沙市妇幼保健院,湖南长沙410012 [2]湖南省人民医院,湖南长沙410005

出　　处：《医学临床研究》2015年第3期573-575,共3页Journal of Clinical Research

摘　　要：【目的】研究比较不同浓度的罗哌卡因腹横肌平面阻滞在剖宫产术后镇痛的临床效果。【方法】选取长沙市妇幼保健院腰部麻醉下行剖宫产的足月孕产妇共300例，由计算机随机排序分为A、B、C三组，每组患者100例，A、B、C组孕产妇术后分别按1．5 mg／kg的规格给予注射0．15％、0．20％和0．25％的罗哌卡因，所有患者均使用镇痛泵辅助镇痛。详细观察并记录三组患者术后不同时间节点的视觉模拟评分（VAS ）评分、患者镇痛泵按压次数以及产妇对镇痛效果的满意程度及腹横肌平面阻滞并发症情况。【结果】A组产妇的VAS评分高于B组和C组，且两者相比差异均具有显著性（ P＜0．05）；24 h后B组产妇的VAS评分与C组相比差异具有统计学意义（ P ＜0．05）；三组产妇镇痛满意度分别为71．0％、91．0％和95．0％，A组与B组，C组相比差异具有统计学意义（ P ＜0．05）；A组产妇术后按压镇痛泵次数明显高于B组和C组，且两者相比差异均具有统计学意义（ P ＜0．05）。三组产妇均无并发症发生。【结论】0．20％及0．25％的罗哌卡因腹横肌平面阻滞用于剖宫产产妇术后的镇痛效果显著而且具有较高的安全性，值得临床推广应用。[Objective] To explore the clinical efficacies of different doses of ropivacaine for post‐cesarean delivery analgesia controlled by transversus abdominis plane blockage .[Methods]A total of 300 cases of lying‐in women ,receiving morphine under spinal anesthesia for caesarean delivery ,were divided randomly into A ,B and C groups （ n =100 each） .They received an injection of 0 .15% ,0 .20% and 0 .25% 1 .5 mg/kg ropiva‐caine respectively .Patient‐controlled analgesia （PCA） was applied for pain alleviation .Visual analogue scale （VAS） scores ,frequency of PCA demand ,patient satisfaction on PCA and complications of transversus abdo‐minis plane blockage were observed and recorded at various timepoints .[Results] The VAS scores of group A were higher than those of group B or group C .And the differences were significantly different （ P〈0 .05）;at 24h ,the VAS scores were significantly different between groups B and C （ P 〈0 .05）;the PAC satisfaction levels of groups A ,B and C were 71 .0% 、91 .0% and 95 .0% respectively .As compared with group B or group C ,group A had statistic differences （ P 〈0 .05）;the frequency of PAC demand was greatly higher for group A than those for groups B and C .And the differences were statistically significant （ P〈0 .05） .For all three groups ,there was no onset of complications .[Conclusion] The uses of 0 .20% and 0 .25% ropivacaine for post‐cesarean delivery analgesia controlled by transversus abdominis plane blockage have remarkable pro‐files of efficacy and safety .And it is worthy of wider popularization .

关 键 词：酰胺类/投药和剂量 腹肌 麻醉  硬膜外/方法 剖宫产术 疼痛  手术后/药物疗法 

分 类 号：R719.8[医药卫生—妇产科学]