舒芬太尼与曲马多静脉自控镇痛联合腰方肌阻滞用于剖宫产术后镇痛的效果比较  

Comparison of analgesia effects of patient controlled intravenous analgesia with sufentanil and tramadol combined with quadratus lumborum block after cesarean section

作　　者：张永琼[1,2] 冉伟 高进 ZHANG Yongqiong;RAN Wei;GAO Jin(Chongqing Medical University,Chongqing 400016;Chongqing Fuling District Maternal and Child Health Care,Chongqing 408000;the First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)

机构地区：[1]重庆医科大学,重庆400016 [2]重庆市涪陵区妇幼保健院,重庆408000 [3]重庆医科大学附属第一医院,重庆400000

出　　处：《临床医学研究与实践》2023年第8期71-74,共4页Clinical Research and Practice

摘　　要：目的比较舒芬太尼与曲马多静脉自控镇痛(PCIA)联合腰方肌阻滞(QLB)用于剖宫产术后镇痛的效果。方法选择重庆医科大学附属第一医院2022年1月至6月接收的84例择期硬膜外麻醉下行剖宫产术产妇为研究对象。经过编号、计算机随机分组工具分组、剔除4例不符合研究病例,本研究设置舒芬太尼PCIA联合QLB组(S组)和曲马多PCIA联合QLB组(T组),各40例。两组产妇术毕均行超声引导下双侧QLB,术后均开展PCIA。S组镇痛泵药物选择舒芬太尼,T组镇痛泵药物选择曲马多。比较两组的干预效果。结果S组术后6、12、24、48 h静息状态视觉模拟评分法(VAS)评分低于T组,差异具有统计学意义(P<0.05);S组术后6、12 h子宫按压时VAS评分低于T组,差异具有统计学意义(P<0.05);S组术后12、24、48 h运动状态VAS评分低于T组,差异具有统计学意义(P<0.05)。S组术后48 h的镇痛泵总用药量及有效按压次数均少于T组,差异具有统计学意义(P<0.05)。S组的首次下床活动时间早于T组,差异具有统计学意义(P<0.05)。S组术后第2、3天子宫出血量少于T组,差异具有统计学意义(P<0.05)。两组术后48 h恶心呕吐、头晕、肠胀气发生率及不良反应总发生率比较,差异无统计学意义(P>0.05)。结论剖宫产术后舒芬太尼PCIA联合QLB是一种安全、有效的镇痛方法,其镇痛效果优于曲马多PCIA联合QLB,可减少术后PCIA用药量及子宫出血量,促进产妇恢复。Objective To compare the analgesia effects of patient controlled intravenous analgesia(PCIA) with sufentanil and tramadol combined with quadratus lumborum block(QLB) after cesarean section. Methods From January to June 2022,84 parturients undergoing elective cesarean section under epidural anesthesia in the First Affiliated Hospital of Chongqing Medical University were selected as the research objects. After numbering, computer random grouping tool grouping,excluding 4 cases of non-conforming research cases, this study inclued sufentanil PCIA combined with QLB group(group S)and tramadol PCIA combined with QLB group(group T), with 40 cases in each group. Ultrasound-guided bilateral QLB was performed in both groups after operation, and PCIA was performed after operation. Sufentanil was selected as the analgesic pump drug in the group S, and tramadol was selected as the analgesic pump drug in the group T. The intervention effects of the two groups were compared. Results The Visual Analogue Scale(VAS) score at resting state in the group S was lower than that in the group T at 6, 12, 24, 48 h after operation, and the difference was statistically significant(P<0.05);the VAS score during uterine compression in the group S was lower than that in the group T at 6 and 12 h after operation,and the difference was statistically significant(P<0.05);the VAS score at motion state in the group S was lower than that in the group T at 12, 24 and 48 h after operation, and the difference was statistically significant(P<0.05). The total dosage and effective pressing times of analgesia pump in the group S were less than those in the group T at 48 h after operation,and the differences were statistically significant(P<0.05). The time of first ambulation in the group S was earlier than that in the group T, and the difference was statistically significant(P <0.05). The amount of uterine bleeding in the group S was less than that in the group T on the 2nd and 3rd day after operation, and the difference was statistically significant(P <0.05)

关 键 词：舒芬太尼 曲马多 静脉自控镇痛 腰方肌阻滞 剖宫产 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]