地塞米松复合罗哌卡因腹横筋膜阻滞在剖宫产术后切口疼痛的镇痛效果观察

The effects observation of dexamethasone combined with ropivacaine TAP block after cesarean section

目的 :观察地塞米松复合罗哌卡因腹横筋膜阻滞在剖宫产术后切口疼痛的镇痛效果。方法:选择行剖宫产手术患者50例,随机分为试验组(地塞米松复合罗哌卡因)和对照组(罗哌卡因组),所有患者于蛛网膜下腔阻滞麻醉下行剖宫产术,术后行腹横筋膜阻滞,分别给予地塞米松5mg复合0.25%罗哌卡因20ml(实验组)及0.25%罗哌卡因20 ml(对照组)。观察术后2、4、8、12、16、24h时静息和运动视觉模拟(VAS)评分,术后镇痛泵的按压次数,以及恶心呕吐的发生率。结果:试验组术后24h静息VAS评分试验组低于对照组(P<0.05);试验组16、24h运动VAS评分试验组低于对照组(P<0.05);术后恶心呕吐发生率试验组低于对照组(P<0.05)。结论:地塞米松复合罗哌卡因可延长腹横筋膜阻滞在剖宫产术后镇痛的作用时间,镇痛效果良好。

Objective： To observe the postoperative analgesic effects of transverses abdominis plane （TAP） block with dexamethasone and ropivacaine on patients undergoing caesarean delivery.Methods： Choose cesarean section patients 50 cases were randomly divided into experimental group （dexamethasone combined with ropivacaine） and control group （ropivacaine group）.All patients underwent cesarean section under subarachnoid block anesthesia, and the patients received bilateral US-guided TAP blocks with total 40 ml of 0.375% ropivacaine and 10 mg dexamethasone （experimental group） and 40 ml of 0.375% ropivacaine （control group）, respectively.To record VAS scores at 2, 4, 8, 12, 16, 24 h , PCIA pressing times and incidence of vomiting after the operation.Result： The resting VAS score of the experimental group was less than that the control group at 24h after the operation （P〈0.05）.The exercise VAS score of the experimental group was less than that the control group at 16, 24h （P〈0.05） after the operation.The incidence of postoperative nausea and vomiting in the experimental group was lower than that in the control group （P〈0.05）.Conclusion： Dexamethasone combined with ropivacaine can extend the TAP block in cesarean section analgesia action time, good analgesic effect, with linical application value.