布托啡诺静脉镇痛联合腹横肌平面阻滞在剖宫产术后镇痛中的临床应用  

Butorphanol intravenous analgesia combined with transversal abdominis plane block in postoperative analgesia after cesarean section

作　　者：刘丽华 姚军[2] 颜景佳 卢清旺 LIU Lihua;YAO Jun;YAN Jingjia;LU Qingwang(Department of Anesthesiology,Jinjiang Hospital,Jinjiang,Fujian 362200,China;Department of Anesthesiology,Shanghai Sixth People’s Hospital,Shanghai 200000,China)

机构地区：[1]晋江市医院麻醉科,福建晋江362200 [2]上海市第六人民医院麻醉科,上海200000

出　　处：《重庆医学》2023年第23期3615-3619,共5页Chongqing medicine

基　　金：福建省泉州市科技高层次人才创新项目(2018C058R)。

摘　　要：目的探讨布托啡诺静脉镇痛联合腹横肌平面阻滞在剖宫产术后镇痛中的应用效果。方法选取2021年8月至2022年1月在晋江市医院行剖腹产的120例产妇为研究对象,根据产妇术后镇痛方法的不同分为3组:A组采用静脉镇痛(100 mL生理盐水含有3μg/kg布托啡诺+25 mg多拉司琼,2 mL/h,持续镇痛48 h);B组采用静脉镇痛(100 mL生理盐水含有3μg/kg布托啡诺+25 mg多拉司琼,2 mL/h,持续镇痛48 h)联合腹横肌平面阻滞(双侧各给予0.5%罗哌卡因10 mL);C组采用静脉镇痛(100 mL生理盐水含有2μg/kg布托啡诺+25 mg多拉司琼,2 mL/h,持续镇痛48 h)联合腹横肌平面阻滞(双侧均给予0.5%罗哌卡因10 mL),对比3组产妇术后4、8、12、24、48 h镇痛的视觉模拟量表(VAS)评分,头晕、嗜睡、恶心呕吐等不良反应发生率及对镇痛的满意度。结果术后4、8、12 h B组和C组VAS评分均明显低于A组(P<0.05),B组和C组VAS评分比较差异无统计学意义(P>0.05);术后24、48 h VAS评分3组间差异无统计学意义(P>0.05)。A、B组头晕、嗜睡、恶心呕吐等不良反应发生率无明显差异且均高于C组;术后4、8、12、24、48 h镇痛满意度:C组>B组>A组。结论布托啡诺静脉镇痛复合腹横肌平面阻滞可减少布托啡诺用量,减轻阿片类药物的不良反应,提高患者术后镇痛的满意度。Objective To investigate the efficacy of butorphanol intravenous analgesia combined with transversus abdominal plane block in postoperative analgesia after cesarean section.Methods A total of 120 cases of cesarean section performed in Jinjiang Hospital from August 2021 to January 2022 were selected for the study.The cases were divided into three groups,according to the different methods of maternal postoperative analgesia,the group A was treated with intravenous analgesia(100 mL normal saline containing 3μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h);the group B received intravenous analgesia(100 mL normal saline containing 3μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h)combined with transverse abdominal plane block(0.5%ropivacaine given bilaterally on each side).2μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h combined with transversus abdominis plane block(10 mL of 0.5%ropivacaine was given bilaterally),and intravenous analgesia in the group C(100 mL of saline containing 2μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h)combined with transversus abdominis plane block(0.5%ropivacaine 10 mL was given bilaterally),and the three groups were compared in terms of the VAS scores of postoperative analgesia at 4,8,12,24 and 48 h,the occurrence of the incidence of adverse reactions,such as dizziness,drowsiness,nausea,and vomiting,and the satisfaction with the analgesia.satisfaction of analgesia.Results Comparison of analgesic effect between groups,the VAS of group B and group C were significantly lower than those of group A at 4,8 and 12 h after surgery(P<0.05),but there was no significant difference between group B and group C in pain scores(P>0.05),and postoperative 24,48 h pain scores of the three groups are not statistically different(P>0.05).In terms of the incidence of adverse reactions such as dizziness,drowsiness,nausea and vomiting,there was no significant difference in the incidence of adverse reactions betwee

关 键 词：布托啡诺 腹横筋膜阻滞 剖宫产 术后镇痛 静脉镇痛 

分 类 号：R614[医药卫生—麻醉学]