超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵在腰-硬联合麻醉剖宫产术后产妇中的应用  

Application of Ultrasound-Guided Bilateral Transversus Abdominis Plane Block Combined with Patient-Controlled Intra-venous Analgesia Pump in Puerperae after Cesarean Section under Combined Spinal-Epidural Anesthesia

作　　者：季兆亚 丁俊珊 孙燕[1] JI Zhaoya;DING Junshan;SUN Yan(Department of Anesthesiology,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450003,China;Department of Gynecology,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州市妇幼保健院麻醉科,河南郑州450003 [2]郑州市妇幼保健院妇科,河南郑州450003

出　　处：《临床医学工程》2024年第11期1297-1298,共2页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230764)。

摘　　要：目的探讨超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵在腰-硬联合麻醉剖宫产术后产妇中的应用效果。方法选取2022年5月至2023年6月在我院接受腰-硬联合麻醉剖宫产手术的104例产妇,根据术后镇痛方式不同分为参照组(51例)和研究组(53例)。参照组术后予以常规腹横肌平面阻滞复合静脉自控镇痛泵进行镇痛,研究组术后予以超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵进行镇痛,均持续干预至出院。比较两组产妇术后疼痛程度、镇痛泵按压次数、首次下地活动时间、术后住院时间及不良反应。结果研究组术后6 h、12 h的VAS评分低于参照组(P<0.05)。研究组镇痛泵按压次数少于参照组,首次下地活动时间、住院时间短于参照组(P<0.05)。研究组不良反应发生率为5.66%,低于参照组的19.61%(P<0.05)。结论腰-硬联合麻醉剖宫产术后产妇应用超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵的镇痛效果较好,能明显促进产妇术后尽快恢复,减少不良反应的发生。Objective To explore and analyze the application effect of ultrasound-guided bilateral transversus abdominis plane block combined with patient-controlled intravenous analgesia pump in puerperae after cesarean section under combined spinal-epidural anesthesia.Methods 104 puerperae undergoing cesarean section under combined spinal-epidural anesthesia in our hospital from May 2022 to June 2023 were selected and divided into reference group(51 cases)and study group(53 cases)according to different postoperative analgesia methods.The reference group was given routine transversus abdominis plane block combined with patient-controlled intravenous analgesia pump for analgesia after operation,and the study group was given ultrasound-guided bilateral transversus abdominis plane block combined with patient-controlled intravenous analgesia pump for analgesia after operation.The postoperative pain degree,the number of analgesic pump compressions,first ambulation time,postoperative hospitalization time and adverse reactions were compared between the two groups.Results 6 hours and 12 hours after operation,the VAS scores of the study group were lower than those of the reference group(P<0.05).The number of analgesic pump compressions in the study group was fewer than that in the reference group,and the first ambulation time and postoperative hospitalization time was shorter than that in the reference group(P<0.05).The incidence of adverse reactions in the study group was 5.66%,lower than 19.61%in the reference group(P<0.05).Conclusions Ultrasound-guided bilateral transversus abdominis plane block combined with patient-controlled intravenous analgesia pump has good analgesic effect in puerperae after cesarean section under combined spinal-epidural anesthesia,which can significantly promote the recovery of puerperae as soon as possible after operation and reduce the adverse reactions.

关 键 词：腰-硬联合麻醉 剖宫产 超声引导下双侧腹横肌平面阻滞 静脉自控镇痛泵 疼痛程度 

分 类 号：R614[医药卫生—麻醉学]