超声引导下行双侧腹横肌平面阻滞对产妇术后镇痛和舒芬太尼用量及血清催乳素水平的影响  

Effects of Ultrasound-guided Bilateral Transversus Abdominis Plane Blocking on Postoperative Analgesia,Sufentanil Dosage and Serum PRL Level in Women after Caesarean Section

作　　者：全耀晨 吴超 刘路 周脉涛[1] QUAN Yao-chen;WU Chao;LIU Lu;ZHOU Mai-tao(Department of Anesthesiology,101 Hospital of PLA,Wuxi,Jiangsu 214044,China)

机构地区：[1]解放军101医院麻醉科,江苏无锡214044

出　　处：《解放军医药杂志》2018年第11期94-97,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨超声引导下行双侧腹横肌平面阻滞对产妇术后镇痛、舒芬太尼用量及血清催乳素(PRL)水平的影响。方法选取解放军101医院2016年7月—2017年10月剖宫产术产妇80例,美国麻醉医师协会分级为Ⅰ级或Ⅱ级,并给予舒芬太尼经静脉患者自控镇痛(PCIA),按照术后是否在超声引导下行双侧腹横肌平面阻滞分为观察组和对照组,每组40例。观察组术后在超声引导下行双侧腹横肌平面阻滞,对照组未行腹横肌平面阻滞。比较两组术后2、6、12、24、48 h的视觉疼痛(VAS)评分,初乳时间及术后24、48 h血清PRL水平,术后24 h内镇痛泵按压次数、镇痛补救率及舒芬太尼用量。结果观察组术后2、6、12、24 h时VAS评分均低于对照组(P<0.05);观察组初乳时间于对照组,术后48 h母乳喂养率高于对照组(P<0.05);术后24、48 h观察组血清PRL水平均高于对照组(P<0.05);观察组术后24 h镇痛泵按压次数、镇痛补救率及舒芬太尼用量均低于对照组(P<0.05)。结论超声引导下行双侧腹横肌平面阻滞增强剖宫产产妇的镇痛效果,减少舒芬太尼用量,促进及早泌乳,值得临床重视。Objective To investigate effects of ultrasound-guided bilateral transversus abdominis plane blocking on postoperative analgesia, Sufentanil dosage and serum prolactin （PRL） level in women after caesarean section. Methods A total of 80 women undergoing cesarean section admitted during July 2016 and October 2017, who were gradeⅠ or Ⅱ American society of anesthesiologists （ASA） and received Sufentanil patient-controlled intravenous analgesia （PCIA）, were divided into observation group （ n =40） and control group （ n =40） according to whether or not having ultrasound-guided bilateral transversus abdominis plane blocking. Observation group received postoperative ultrasound-guided bilateral transversus abdominis plane blocking, while control group did not undergo transversus abdominis plane blocking. visual analogue scales （VAS） scores at 2 nd , 6 th , 12 th , 24 th and 48 th h after surgery, colostrum time, serum PRL levels at 24 th and 48 th h after surgery, pressing times of analgesia pump within postoperative 24 h, redeem rate of analgesia and Sufentanil dosage were compared between two groups. Results Compared with those in control group, in observation group, VAS scores at 2 nd , 6 th , 12 th and 24 th h after surgery were significantly lower （ P 〈0.05）; colostrum time was shorter, and rate of breast feeding in 48 th h after surgery was significantly higher （ P 〈0.05）; serum PRL levels in 24 th and 48 th h after surgery were significantly higher （ P 〈0.05）; values of pressing times of analgesia pump within postoperative 24 h, redeem rate of analgesia and Sufentanil dosage were significantly lower （ P 〈0.05）. Conclusion Ultrasound-guided bilateral transversus abdominis plane blocking may improve analgesic effect of cesarean section, reduce use of Sufentanil dosage and promote maternal lactation as early as possible.

关 键 词：腹横肌平面阻滞 剖宫产术 术后镇痛 舒芬太尼 催乳素 

分 类 号：R614.4[医药卫生—麻醉学]