微创腰麻联合腹横肌平面阻滞用于剖宫产术的临床观察

The Clinical Observation of Minimally Invasive Spinal Anesthesia Combined with Transversus Abdominis Plane Block in Cesarean Section

目的:比较微创腰麻(MSA)联合腹横肌平面阻滞(TAPB)与传统腰硬联合麻醉(CSEA)辅以硬膜外镇痛(PCEA)用于剖宫产术在术后镇痛效果、首次术后下床活动时间、麻醉相关并发症发生情况进行临床观察。方法:以择期行剖宫产术的患者120例为研究对象,根据麻醉方法不同随机分为试验组(MSA+TAPB)与对照组(CSEA+PCEA),每组各60例。观察比较两组患者术后各随访时点的VAS评分、产妇术后首次下床活动时间、麻醉相关并发症发生情况。结果:两组患者在术后24 h以内VAS评分比较差异均无统计学意义(P>0.05),术后24~48 h VAS评分比较差异有统计学意义(P<0.05)。两组患者在术后首次下床活动时间、麻醉相关并发症发生情况比较差异均有统计学意义(P<0.05)。结论:微创腰麻联合腹横肌平面阻滞用于剖宫产术在基层医院值得临床选用。

Objective：To compare minimally invasive spinal anesthesia （MSA） combined with transversus abdominis plane block （TAPB） and traditional lumbar epidural anesthesia （CSEA） combined with epidural analgesia （PCEA） for cesarean section in postoperative analgesia for the first time,postoperative ambulation time,anesthesia related complications in clinical observation.Method：The patients undergoing elective cesarean section in 120 cases as the research objects,according to the different methods of anesthesia were randomly divided into experimental group （MSA＋TAPB） and control group （CSEA＋PCEA）,60 cases in each group.The VAS score of postoperative follow-up time points,the first time after the operation,and the incidence of anesthesia related complications of two groups were observed and compared.Result：There was no significant difference in VAS score between the two groups（P〉0.05）;within 24-48 hours after operation,there was significant difference in VAS score between the two groups（P〈0.05）.Two groups of patients in the first postoperative ambulation time,anesthesia related complications were significantly different（P〈0.05）.Conclusion：Minimally invasive spinal anesthesia combined with transversus abdominis plane block for cesarean section is worth clinical use in primary hospital.