超声引导腹横肌平面阻滞联合七氟醚全麻对剖宫产产妇应用研究  

Application of Ultrasound Guided Transverse Abdominal Muscle Block Combined with Sevoflurane General Anesthesia in Cesarean Section

作　　者：朱林夕 ZHU Lin-xi(Department of Anesthesia,Pingdingshan Maternal and Child Health Hospital,Pingdingshan 467000,Henan Province,China)

机构地区：[1]平顶山市妇幼保健院麻醉科,河南平顶山467000

出　　处：《罕少疾病杂志》2022年第10期74-75,78,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探究超声引导腹横肌平面阻滞(TAPB)联合七氟醚全麻应用于剖宫产产妇血中的效果。方法回顾性分析2020年4月至2021年3月于我院行剖宫产的产妇76例,按麻醉方式分为对照组与观察组,各38例。对照组实施腰硬联合麻醉,观察组在超声辅助下使用利多卡因+罗哌卡因行双侧TAPB联合七氟醚全麻。比较两组麻醉前(T_(1))、麻醉后2min(T_(2))、术毕(T_(3))血流动力学指标[心率(HR)、平均动脉压(MAP)]、新生儿Apgar评分及产妇不良反应。结果观察组T_(2)、T_(3)时HR、MAP与T_(1)时比较,无统计学差异(P>0.05);对照组T_(2)时HR高于T_(1)时HR,T_(2)、T_(3)时MAP低于T_(1)时,有统计学差异(P<0.05);观察组T_(2)、T_(3)时HR低于对照组,MAP高于对照组,无统计学差异(P<0.05);新生儿娩出后1min、5min,两组Apgar评分比较,有统计学差异(P>0.05);对照组恶心呕吐发生率高于观察组,(P<0.05)。结论TAPB联合七氟醚全麻可有效维持剖宫产产妇术中血流动力学稳定,减少不良反应,且不影响新生儿状况。Objective To investigate the effect of ultrasound guided transverse abdominal muscle block(TAPB)combined with sevoflurane general anesthesia in the blood of cesarean section women.Methods Retrospective analysis was made on 76 cases of parturients who underwent cesarean section in our hospital from April 2020 to March 2021.According to the mode of anesthesia,they were divided into control group and observation group,38 cases in each group.The control group received combined spinal epidural anesthesia,while the observation group received bilateral TAPB combined with sevoflurane general anesthesia with lidocaine and ropivacaine under ultrasound assistance.The hemodynamic indexes,Apgar score of newborns and adverse reactions of parturients before anesthesia(T_(1)),2 minutes after anesthesia(T_(2)),and at the end of surgery(T_(3))were compared between the two groups.Results There was no significant difference in HR and MAP between T_(2),T_(3) and T_(1) in the observation group(P>0.05);In the control group,HR at T_(2) was higher than that at T_(1),and MAP at T_(2) and T_(3) was lower than that at T_(1),with statistical difference(P<0.05);HR at T_(2) and T_(3) in the observation group was lower than that in the control group,while MAP was higher than that in the control group(P<0.05);At 1 min and 5 min after delivery,there was no significant difference in Apgar scores between the two groups(P>0.05);The incidence of nausea and vomiting in the control group was significantly higher than that in the observation group(P<0.05).Conclusion TAPB combined with sevoflurane general anesthesia can effectively maintain the stability of hemodynamics during cesarean section,reduce adverse reactions,and do not affect the condition of the newborn.

关 键 词：剖宫产 超声 腹横肌平面 全身麻醉 血流动力学 

分 类 号：R445.1[医药卫生—影像医学与核医学]