洪丽琼.腰-硬联合麻醉剖宫产术后超声引导双侧TAP阻滞的镇痛优势分析[J].实用中西医结合临床,2021,21(22): |
腰-硬联合麻醉剖宫产术后超声引导双侧TAP阻滞的镇痛优势分析 |
Analgesic advantage analysis of bilateral TAP block guided by ultrasound after caesarean section under combined lumbar epidural anesthesia |
投稿时间:2021-07-26 修订日期:2021-08-16 |
DOI: |
中文关键词: 腰-硬联合麻醉 剖宫产 腹横肌平面阻滞 超声引导 镇痛效果 |
英文关键词: combined lumbar epidural anesthesia Cesarean section Plane block of transverse abdominis Ultrasonic guidance Analgesic effect |
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中文摘要: |
目的:探究超声引导双侧腹横肌平面(TAP)阻滞在腰硬联合麻醉剖宫产术后的镇痛效果。方法:本次研究为前瞻性研究,选取2018年5月-2020年5月在我院行剖宫产手术产妇共计200例为研究对象,采取奇偶数分组法,奇数100例为对照组,偶数100例为观察组,两组产妇均给予腰硬联合麻醉,术后对照组给予静脉自控镇痛,观察组给予静脉自控镇痛联合超声引导双侧TAP阻滞。对两组产妇的术后疼痛程度、舒适度、血清因子、镇痛泵按压次数、并发症及不良反应发生率进行比较。结果:观察组产妇各时点VAS疼痛评分均显著低于对照组(P<0.05);各时点BCS评分均显著高于对照组(P<0.05);术后24h,两组产妇血糖、皮质醇、IL-6水平均高于术前,但观察组显著低于对照组(P<0.05);术后72h后,观察组产妇镇痛泵按压次数、不良反应发生率均低于对照组(P<0.05)。结论:腰硬联合麻醉剖宫产术后采用静脉自控镇痛联合超声引导双侧腹横肌平面阻滞镇痛效果良好,安全性较高,值得推广应用。 |
英文摘要: |
[Abstract] Objective: To explore the analgesic effect of ultrasong-guided bilateral transverse abdominal muscle plane (TAP) block in cesarean section under combined lumbar epidural anesthesia. Methods: This study is a prospective study, and a total of 200 women who underwent cesarean section in our hospital from May 2018 to May 2020 were selected as the study subjects. The odd and even grouping method was adopted, with 100 cases of odd number as the control group and 100 cases of even number as the observation group. Both groups were given combined lumbar epidural anesthesia, and the control group was given intravenous self-controlled analgesia after operation. Observation group was given intravenous controlled analgesia combined with ultrasound-guided bilateral TAP block. The postoperative pain degree, comfort level, serum factors, pressure times of analgesic pump, incidence of complications and adverse reactions were compared between the two groups. Results: VAS pain score in observation group was significantly lower than that in control group at each time point (P<0.05). BCS score at each time point was significantly higher than that of control group (P<0.05); 24h after operation, the levels of blood glucose, cortisol and IL-6 in 2 groups were higher than those before operation, but observation group was significantly lower than control group (P<0.05); 72h after operation, the number of compressions of analgesic pump and the incidence of adverse reactions in observation group were lower than those in control group (P<0.05). Conclusion: After cesarean section under combined lumbar epidural anesthesia, intravenous controlled analgesia combined with ultrasound guided bilateral transversal abdominal muscle block analgesia has good effect, high safety, and is worthy of popularization and application. |
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