剖宫产术后单次硬膜外阻滞与腰方肌阻滞镇痛效果对比  

Comparison on the effect of single epidural block and quadratus lumborum block for postoperative analgesia of women aftercesarean section

作　　者：沈菊芳[1] 邱燕珍 王伟 SHEN Jufang;QIU Yanzhen;WANG Wei(The Second People's Hospital of Yuhang District,Hangzhou,Zhejiang Province,311121)

机构地区：[1]浙江省杭州市余杭区第二人民医院,311121

出　　处：《中国计划生育学杂志》2023年第7期1571-1575,共5页Chinese Journal of Family Planning

基　　金：2021年浙江省健康卫生健康科技计划项目(2021ZH008)。

摘　　要：目的:探讨单次硬膜外阻滞与腰方肌阻滞在剖宫产术后镇痛效果对比。方法:选取2019年6月—2022年6月本院行剖宫产产妇94例,随机分为两组各47例,硬膜组予以单次硬膜外阻滞;腰方肌组产妇予以腰方肌阻滞。比较两组数字疼痛评分法(NRS)、Bromage运动评分、首次下床时间、首次运动时间、首次按压时间、有效按压次数、镇痛满意度、尿潴留、行动过缓、呼吸抑制及术后恶心呕吐发生情况。结果:静息时及运动时术后12h、24h NRS评分两组无差异(P>0.05),术后4h、8h NRS评分腰方肌组均低于硬膜组(均P<0.05);两组术后各时间点Bromage评分无差异(P>0.05);腰方肌组有效按压次数(51.3±18.1次)低于硬膜组(64.1±22.7次),镇痛满意度(8.72±0.90分)高于硬膜组(8.01±0.88分),尿潴留(8.5%)、不良反应总发生率(21.3%)低于硬膜组(23.4%、42.6%)(均P<0.05)。结论:与单次硬膜外阻滞相比,腰方肌阻滞在剖宫产术后镇痛效果更好,产妇镇痛满意度高,可降低不良反应发生率。Objective:To explore the comparison on the effect of single epidural block and quadratus lumborum block for postoperative analgesia of women after cesarean section.Methods:A total of 94women who wanted cesarean section were enrolled and were randomly divided into group A(47women with single epidural block for postoperative analgesia)and group B(47women with quadratus lumborum block for postoperative analgesia)between June 2019and June 2022.The scores of numerical rating scale(NRS)and Bromage exercise,the time of the first getting out of bed,the first exercise time,the first press time,the number of effective pression,the analgesia satisfaction,and the situations of urinary retention,slow action,respiratory depression,and postoperative nausea and vomiting(PONV)of the women were compared between the two groups.Results:The NRS score at rest and in exercise of the women at 12h and 24hafter surgery had no significant differences between the two groups(P>0.05),and the NRS score of the women at 4hand 8hafter surgery in group B was significantly lower than that of the women in group A(all P<0.05).There was no significant difference in the Bromage score of the women at each time point after surgery between the two groups(P>0.05).The number of effective pressions(51.3±18.1times)of the women in group B was significantly lower than that(64.1±22.7times)of the women in group A,and the satisfaction of analgesia(8.72±0.90points)of the women in group B was significantly higher than that(8.01±0.88points)of the women in group A.The rates of urinary retention(8.5%)and overall incidence of adverse reactions(21.3%)of the women in group B were significantly lower than those(23.4%and 42.6%)of the women in group A(P<0.05).Conclusion:Compared with those of single epidural block,quadratus lumborum block for postoperative analgesia has better analgesia effect and higher analgesia satisfaction of the women who had undergone cesarean section,and which can reduce the incidence of the adverse reaction of the women.

关 键 词：剖宫产 术后镇痛 腰方肌阻滞 单次硬膜外阻滞 效果比较 

分 类 号：R614[医药卫生—麻醉学]