超声引导下连续腹横肌平面阻滞对剖宫产产妇术后镇痛的效果

发布时间：2018-08-29 08:02

【摘要】：目的观察超声引导下连续腹横肌平面(TAP)阻滞对剖宫产产妇术后镇痛的效果。方法选择择期行剖宫产手术的健康适龄产妇75例,根据随机数字表法将其分为A、B、C组各25例。各组均于腰麻-硬膜外阻滞下行剖宫产手术。术后A组超声引导下连续TAP阻滞镇痛,B组超声引导下双侧单次TAP阻滞镇痛联合硬膜外患者自控镇痛(PCA),C组单纯采用硬膜外PCA,镇痛药物均为0.375%罗哌卡因。分别于术后2 h(T1)、6 h(T2)、12 h(T3)、24h(T4)、48 h(T5)记录静息视觉模拟评分(VAS)、运动VAS、舒适度评分(BCS)和Ramsay镇静评分,记录各组术后48 h内PCA按压次数、PCA总消耗量、静脉给予镇痛药物情况、不良反应。结果与B、C组比较,A组术后静息VAS、运动VAS、Ramsay低,BCS高(P均0.05);术后PCA按压次数、PCA总消耗量少(P均0.05)。A、B组静脉给予镇痛药物比例较C组低(P均0.05)。A组低血压、恶心呕吐发生率较C组低(P均0.05)。结论超声引导下连续TAP阻滞对剖宫产产妇术后镇痛的效果优于单次TAP联合硬膜外PCA、单纯硬膜外PCA。
[Abstract]:Objective to observe the analgesic effect of continuous abdominal transverse muscle (TAP) block guided by ultrasound in postpartum caesarean section. Methods Seventy-five healthy parturients who underwent cesarean section were randomly divided into two groups: group A (n = 25) and group C (n = 25). All groups underwent cesarean section under spinal-epidural block. Group A received continuous TAP block analgesia under ultrasound guidance and group B received bilateral TAP block analgesia under ultrasound guidance combined with patient-controlled epidural analgesia (PCA) group C was treated with epidural PCA, analgesia only 0.375% ropivacaine. Rest visual analogue score (VAS), VAS, comfort score (BCS) and Ramsay sedative score were recorded at 2 h (T 1) 6 h (T 2) and 12 h (T 3) 24 h (T 4) and 48 h (T 5), respectively. The total PCA consumption was recorded within 48 h after operation. Results compared with group C, the resting VAS, exercise VAS,Ramsay in group A was lower than that in group B (P 0.05), and the total consumption of PCA in group A was lower than that in group C (P 0.05). The incidence of nausea and vomiting in group A was lower than that in group C (P 0.05), and the incidence of nausea and vomiting in group A was lower than that in group C (P 0.05). Conclusion Ultrasound-guided continuous TAP block is superior to single TAP combined with epidural PCA, for postoperative analgesia of cesarean section.
【作者单位】：莱芜市人民医院;
【分类号】：R719.8

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