超声引导的腹横肌平面阻滞在剖宫产腰麻硬膜外联合麻醉术中的应用效果分析  

Application of ultrasound-guided abdo transverse plane block in cesarean section combined with spinal anesthesia for epidural anesthesia and observation of postoperative results

作　　者：陈代明 Chen Daiming(Ya'an CityMingshan People's Hospital, Ya'an,Sichuan 625100, China)

机构地区：[1]雅安市名山区人民医院,四川雅安625100

出　　处：《医药前沿》2019年第17期35-37,共3页Journal of Frontiers of Medicine

摘　　要：目的:分析超声引导下腹横肌平面阻滞(TAP)在剖宫产腰麻硬膜外联合麻醉中的应用效果.方法:选择我院2017年4月—2018年4月收治的80例剖宫产患者,随机分为两组,对照组40例接受腰麻硬膜外联合麻醉+T A P阻滞麻醉,观察组40例接受腰麻硬膜外联合麻醉+超声引导TAP阻滞麻醉,比较麻醉效果.结果:观察组切皮后、娩出胎儿后、腹腔清理时、手术完成时的心率、平均动脉压水平均低于对照组;观察组术后4、8、16、24、36小时疼痛评分均低于对照组;观察组术中牵拉反射、术后恶心呕吐发生率为22.50%、10%,低于对照组57.50%、32.50%,观察组术后镇痛泵按压次数、术后首次下地时间均少于对照组(P<0.05).结论:超声引导的腹横肌平面阻滞用于剖宫产腰麻硬膜外联合麻醉中能够获得更高的成功率,术后有良好持续镇痛效果.Objective To analyze the application of ultrasound-guided transverse abdominis plane block (TAP) in combined spinal and epidural anesthesia for cesarean section. Metiiods 80 patients with cesarean section from April 2017 to April 1818 in our hospital were selected according to different anesthesia methods. 40 patients in the control group underwent spinal anesthesia combined with anesthesia plus TAP block anesthesia, and 40 patients in the observation group. Underwent spinal anesthesia combined with anesthesia + ultrasoundguided TAP block anesthesia to compare the anesthetic effect Results The heart rate and mean arterial pressure of the observation group were lower than those of the control group after the incision, after delivery of the fetus, when the abdominal cavity was cleaned, and when the operation was completed. The observation group had low pain scores at 4,8,16, 24, and 36 hours after operation. In the control group, the incidence of postoperative traction reflex and postoperative nausea and vomiting in the observation group was 22.50%, 10%, which was lower than that of the control group (57.50%, 32.50%). The number of postoperative analgesic pump presses and the first postoperative time in the observation group. All were less than the control group(P <0.05). Conclusion Ultrasound-guided abdominis plane block can achieve higher success rate in cesarean section combined with spinal epidural anesthesia. It has good sustained analgesia after operation and is worthy of clinical promotion.

关 键 词：超声引导 腹横肌平面阻滞 剖宫产 腰麻 硬膜外联合麻醉 

分 类 号：R713[医药卫生—妇产科学]