对剖宫产术后的患者采用不同的入路进行腹横肌平面阻滞对其镇痛效果的影响

Ultrasound guided transversus abdominis plane block in different approaches of analgesia after cesarean section

目的:探讨对剖宫产手术后的患者采用超声引导下肋缘下入路和超声引导下腋前线入路进行腹横肌平面阻滞对其镇痛效果的影响。方法:选取近年来在南充市中心医院进行剖宫产手术的46例患者作为本研究的对象。将这46例患者分为肋缘下入路组(L组)和腋前线入路组(Y组)。对两组患者均进行剖宫产手术。术后,对L组患者采用超声引导下肋缘下入路进行腹横肌平面阻滞,对Y组患者采用超声引导下腋前线入路进行腹横肌平面阻滞,然后比较两组患者术后各时间点的VAS评分、镇痛药物浓度达到峰值的时间、术毕至下床活动的时间及其对镇痛效果的满意率。结果:两组患者术后8 h、10 h、12 h、24 h及48 h的VAS评分相比差异无统计学意义(P>0.05)。两组患者镇痛药物浓度达到峰值的时间、术毕至下床活动的时间及对镇痛效果的满意率相比差异无统计学意义(P>0.05)。结论:采用超声引导下肋缘下入路和超声引导下腋前线入路对剖宫产手术后的患者进行腹横肌平面阻滞,均能取得良好的镇痛效果。

Objective ：To explore ultrasound guided transversus abdominis plane block in different approaches of analgesia after cesarean section.Method ：46 cases of pregnant women accepted cesarean section were randomly divided into two groups, the lower approach group（group L） and the anterior axillary approach group（group Y）. Undergo cesarean section with transversus abdominis plane block in lower approach for group L,undergo cesarean section with transversus abdominis plane block in anterior axillary approach for group Y. Compare VAS score, peak time of anaesthetic, time of out of bed and satisfaction rate of patients.Result ：There was no significant difference in the analgesic effect of VAS within 48 hours（P〈0.05）, and there was no significant difference between the two groups in their time of bed, satisfaction, and peak time of analgesia（P〈0.05）.Conclusion ： Ultrasound guided transversus abdominis plane block both in lower approach and in anterior axillary approach will achieved good effect.