甲磺酸罗哌卡因腹横肌平面阻滞用于剖宫产术后镇痛的效果观察  

Clinical observation on analgesic efficacy of transversus abdominis plane block for relieving pain in parturients after cesarean section

作　　者：王进[1] 王祥[1] 王广森[1] 

机构地区：[1]南通大学附属海安医院麻醉科,江苏南通226600

出　　处：《临床和实验医学杂志》2016年第21期2162-2164,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察甲磺酸罗哌卡因腹横肌平面阻滞在剖宫产手术术后镇痛效果。方法选择60例剖宫产择期手术患者,随机分成A、B两组。A组患者术毕于硬膜外腔推注2 mg吗啡行术后镇痛,B组患者术毕在超声引导下行双侧超声引导下腹横肌平面阻滞(TAPB)。分别于术后1 h、4 h、8 h、24 h随访病人并记录各时点的疼痛视觉模拟(VAS)评分、患者对镇痛效果的满意度以及术后并发症的发生情况。结果 1两组产妇不同时点VAS评分差异无统计学意义(P>0.05)。2B组镇痛满意度明显高于A组,差异有统计学意义(P<0.05)。3A组皮肤瘙痒和尿潴留的发生率明显高于B组,差异有统计学意义(P<0.05),而两组恶心呕吐和呼吸抑制发生情况差异无统计学意义(P>0.05)。结论超声引导下甲磺酸罗哌卡因腹横肌平面阻滞能为剖宫产手术患者提供良好的术后镇痛,不良反应较少,患者满意度高。Objective The aim of this study is to observe the effect of transversus abdominis plane block for postoperative analgesia in parturients after cesarean section. Methods Sixty patients undergoing cesarean section were randomly derided into two groups. 2 mg morphine was given to patients in group A by epidural drip and the ultrasound - guided bilateral TAP block was performed in patients of group B. Visual ana- log scale （VAS） scores were recorded in 1 h, 4 h, 8 h and 24 h after operation . The satisfaction on analgesia and adverse reactions were also re- corded and compared. Results ①The difference in VAS scores of these two groups was not statistically significant （ P 〉0. 05 ）. ②The satisfaction on analgesia was better in patients of group B than that of patients in group A （ P 〈 0.05 ）. ③ The incidence rates of skin itching and urine retention in group A were higher than those of group B （ P 〈 0. 05 ）. The difference in incidence of nausea, vomiting and respiratory depression was not statistically significant （ P 〉 0. 05 ）. Conclusion The application of ropivacaine mesilate for TAP block under ultrasonic guidance is safe and effective for postoperative analgesia after cesarean section, with less adverse reactions and higher satisfaction of patients.

关 键 词：剖宫产 术后镇痛 甲磺酸罗哌卡因 腹横肌平面阻滞 

分 类 号：R614[医药卫生—麻醉学]