超声引导下腹横肌平面阻滞在剖宫产术后镇痛效果研究  

Study on the analgesic effect of ultrasound guided transversus abdominis plane block in postoperative cesarean section

作　　者：黄进强[1] 邓铸强[1] 陈伟志[1] 梁万益[1] 

机构地区：[1]高州市人民医院麻醉科一区,525200

出　　处：《中国实用医药》2017年第19期133-135,共3页China Practical Medicine

摘　　要：目的探究超声引导下腹横肌平面阻滞在剖宫产术后镇痛效果。方法 80例美国麻醉医师协会(ASA)Ⅰ~Ⅱ级择期腰硬联合麻醉下进行剖宫产术的患者作为研究对象,随机分为A组和B组,各40例。A组患者注射罗哌卡因,而B组则注射等容量的氯化钠溶液。手术完成之后行静脉自控镇痛并在超声引导下腹横肌平面阻滞。记录并分析两组患者术后不同时间点镇痛相关数据以及不良反应发生情况。结果 A组患者各个时间点静态视觉模拟疼痛评分与B组比较差异无统计学意义(P>0.05),各时间点动态视觉模拟疼痛评分均明显低于B组,差异有统计学意义(P<0.05)。A组镇痛泵第一次镇痛按压时间(12.74±3.53)h明显晚于B组的(3.56±2.53)h,镇痛泵按压次数(2.05±0.64)次及药物24 h内剂量(51.23±1.56)μg少于B组的(5.67±2.34)次、(62.23±2.53)μg,差异具有统计学意义(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论超声引导下腹横肌平面阻滞在剖宫产术后镇痛效果较好,值得在临床上推广使用。Objective To explore the analgesic effect of ultrasound guided transversus abdominis plane block in postoperative cesarean section. Methods A total of 80 American Society of Anesthesiologists（ASA） grade Ⅰ~Ⅱ patients with selective cesarean section under combined spinal and epidural anesthesia as study subjects were randomly divided into group A and group B, with 40 cases in each group. Group A received ropivacaine injection, and group B received equal volume of sodium chloride solution injection. They received patient controlled intravenous analgesia and ultrasound guided transversus abdominis plane block after completion of operation. The analgesic related data and occurrence of adverse reactions in two groups were recorded and analyzed at different times after operation. Results Group A had no statistically significant difference in static visual analogue pain scores at each time point comparing with group B（P〈0.05）, and obviously lower dynamic visual analogue pain score at each time point than group B. Their difference had statistical significance（P〈0.05）. Group A had obviously later analgesic pump first analgesic press time as（12.74±3.53） h than（3.56±2.53） h in group B, less analgesic pump pressing times as（2.05±0.64） times and 24 h drug dose as（51.23±1.56） μg than（5.67±2.34） times and（62.23±2.53） μg in group B. Their difference had statistical significance（P〈0.05）. Both groups had no statistically significant difference in incidence of adverse reactions（P〈0.05）. Conclusion Ultrasound guided transversus abdominis plane block shows good analgesic effect in postoperative cesarean section, and it is worthy of clinical promotion and use.

关 键 词：超声引导 腹横肌平面阻滞 镇痛 

分 类 号：R614[医药卫生—麻醉学]