腰方肌阻滞在全身麻醉剖宫产患者术后镇痛中的应用  

Effect of quadratus lumborum block on postoperative analgesia in cesarean section under general anesthesia

作　　者：张洁[1] 李爱媛[1] Zhang Jie;Li Aiyuan(Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China)

机构地区：[1]湖南省妇幼保健院麻醉科

出　　处：《中国医师杂志》2019年第6期806-809,共4页Journal of Chinese Physician

基　　金：湖南省自然科学基金(2016JJ6052)~~

摘　　要：目的观察腰方肌阻滞在全身麻醉剖宫产患者术后镇痛中的应用。方法 50例全身麻醉下行剖宫产手术患者,按随机数字表法分为两组:腰方肌阻滞组(Q组,n=25)患者术毕后超声引导下于双侧后路腰方肌阻滞点注射0. 3%罗哌卡因25 ml,对照组(C组,n=25)患者术毕后相同部位消毒但不行穿刺。记录患者手术后2、6、12、24、48 h疼痛视觉模拟评分(VAS)及疼痛舒适度评分(BCS)。记录患者一般情况、生命体征及术后镇痛相关不良反应。结果两组产妇一般资料及手术相关指标差异无统计学意义(P> 0. 05)。Q组产妇手术后2、6、12、24 h的VAS评分均低于对照组,BCS评分高于对照组(P <0. 05)。两组产妇术后48 h的VAS评分、BCS评分及不良反应发生率比较差异无统计学意义(P> 0. 05)。结论后路腰方肌阻滞联合静脉镇痛可以减轻全身麻醉剖宫产手术产妇术后24 h内疼痛评分,提高术后镇痛舒适度。Objective To observe the analgesic effect of quadratus lumborum block( QLB) in cesarean section under general anesthesia. Methods 50 patients underwent cesarean section under general anesthesia were randomly divided into two groups( n = 25) : patients in QLB group( group Q) received QLB at the end of surgery with 0. 3% ropivacaine 25 ml,and the control group( group C) patients were disinfected at the same site but did not puncture. The visual analogue scale( VAS) and pain Bruggrmann comfort score( BCS) were recorded at 2,6,12,24,and 48 hours after surgery. The patient’s general condition,vital signs and postoperative analgesia-related adverse reactions were recorded. Results There were no significant differences between the two groups in general information and surgical related indexes( P >0. 05). The VAS scores of the Q group were lower than the control group at 2,6,12 and 24 hours,and the BCS score was higher than that in the control group( P < 0. 05). There was no difference in VAS score,BCS score after 48 hours,and no difference in adverse reaction rate between the two groups( P > 0. 05).Conclusions Quadratus lumborum block combined with intravenous analgesia can reduce the pain score within 24 hours after cesarean section under general anesthesia and improve postoperative analgesia comfort.

关 键 词：神经传导阻滞 腰肌 麻醉 全身 剖宫产术 镇痛 

分 类 号：R614[医药卫生—麻醉学] R719.8[医药卫生—外科学]