B超复合神经刺激仪下腹横筋膜阻滞在剖宫产快速康复中的应用  

Transversus abdominis plane block by B-ultrasound combined with nerve stimulator in the rapid recovery of puerpera after cesarean section

作　　者：刘轶 黄元香 刘根凤[1] 黄友芳[1] LIU Yi;HUANG Yuanxiang;LIU Genfeng;HUANG Youfang(Department of Anesthesiology,People's Hospital of Xingguo County,Xingguo 342400,Ganzhou,Jiangxi,China)

机构地区：[1]江西省赣州市兴国县人民医院麻醉科,江西兴国342400

出　　处：《右江医学》2022年第10期742-745,共4页Chinese Youjiang Medical Journal

基　　金：赣州市指导性科技计划项目(GZ2021ZSF668)。

摘　　要：目的探讨B超复合神经刺激仪下腹横筋膜阻滞在促进剖宫产快速康复中的应用效果。方法选取2020年1月—2021年10月住院行剖宫产分娩的产妇60例,按随机数字表分为两组,各30例。对照组予以传统椎管内麻醉,观察组予以B超复合神经刺激仪下腹横筋膜阻滞。比较两组手术情况、血流动力学指标[心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO_(2))]、麻醉恢复情况、疼痛情况[视觉模拟评分法(VAS)]及不良反应发生情况。结果两组手术时间、出血量相比,差异无统计学意义(P>0.05);观察组切皮时(T1)、手术结束时(T2)时HR[(80.36±7.02)次/min、(82.54±7.43)次/min]、MAP[(77.85±5.89)mmHg、(72.11±5.54)mmHg]低于对照组,麻醉恢复时间(25.43±4.25)min、下床活动时间(8.69±1.14)h及肛门排气时间(20.42±3.17)h短于对照组,差异有统计学意义(P<0.05或0.001);观察组术中10 min、20 min及30 min时VAS评分为(2.22±0.31)分、(1.54±0.29)分及(1.05±0.21)分,均低于对照组,差异有统计学意义(P<0.001);两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论B超复合神经刺激仪下腹横筋膜阻滞可提高剖宫产镇痛效果,稳定术中生命体征,缩短术后麻醉恢复时间,促使产妇尽早下床活动。Objective To investigate the application effect of transversus abdominis plane block by B-ultrasound combined with nerve stimulator in the rapid recovery of puerpera after cesarean section in promoting the rapid recovery of puerpera after cesarean section.Methods 60 puerperae having cesarean section in People's Hospital of Xingguo County from January 2020 to October 2021 were selected and divided into two groups according to the random number table method,with 30 cases in each.The control group was given traditional intraspinal anesthesia,and the study group was given transversus abdominis plane block by B-ultrasound combined with nerve stimulator.The surgical conditions,hemodynamic indices(heart rate,HR;mean arterial pressure,MAP;and blood oxygen saturation,SpO_(2)),anesthesia recovery,pain(visual analogue scale,VAS),and adverse reactions were compared between the two groups.Results There was no statistically significant difference in operation time and blood loss between the two groups(P>0.05).The HR[(80.36±7.02)times/min,(82.54±7.43)times/min]and MAP[(77.85±5.89)mmHg,(72.11±5.54)mmHg]in study group at the time of skin incision(T1)and at the end of the operation(T2)respectively were lower than those in control group,and the anesthesia recovery time[(25.43±4.25)min],ambulation time[(8.69±1.14)h],and anal exsufflation time[(20.42±3.17)h]in study group were shorter than those in control group,which were all statistically significantly different(P<0.05 or 0.001).The VAS scores at 10 min,20 min and 30 min during operation were(2.22±0.31)points,(1.54±0.29)points,and(1.05±0.21)points in the observation group,which were lower than those in control group,and the differences were statistically significant(P<0.001).There was no significant difference in the incidences of adverse reactions between the two groups(P>0.05).Conclusion Transversus abdominis plane block by B-ultrasound combined with nerve stimulator can improve the analgesic effect of cesarean section,stabilize vital signs during operation,shorten the

关 键 词：剖宫产 腹横筋膜阻滞 B超 神经刺激仪 椎管内麻醉 快速康复 

分 类 号：R614[医药卫生—麻醉学]