耳穴埋豆对剖宫产患者术后疼痛的影响

Efficacy of auricular point therapy for postoperative analgesia of cesarean section

目的观察耳穴埋豆对剖宫产术后疼痛的影响。方法选取我院2015年4~12月腰硬联合麻醉下行剖宫产术者100例,随机分为Ⅰ组和Ⅱ组,各50例。两组术后均使用硬膜外镇痛,同时Ⅱ组在右侧耳穴埋豆。观察术后6 h、12 h、18 h、24 h、36 h各时段镇痛泵有效按压次数和用药量,伤口静息痛和宫缩痛的视觉模拟评分法(visual ana-logue score,VAS)评分,宫缩痛发生时按压耳豆的有效率,术后排气时间及不良反应。结果两组在术后6 h、12 h、18h、24 h、36 h各时段镇痛泵有效按压次数和用药量差异均无统计学意义(P>0.05);两组伤口静息痛VAS评分差异无统计学意义(P>0.05);Ⅱ组宫缩痛VAS评分12 h、18 h、24 h、36 h明显低于Ⅰ组(12 h、18 h时P<0.05,24 h、36 h时P<0.01);Ⅱ组术后排气时间明显早于Ⅰ组(P<0.05);两组均无不良反应发生。结论耳穴埋豆能进一步减轻剖宫产术后使用硬膜外镇痛产妇的宫缩痛,并促进胃肠功能的恢复。

Objective To evaluate the efficacy of auricular point therapy combined with epidural anesthesia for postoperative analgesia of cesarean section. Methods A total of 100 patients underwent cesarean section with epidural anesthesia were randomly divided into groupⅠ and groupⅡ, with fifty cases in each group. The groupⅡ received auricular seed pressing therapy combined with epidural anesthesia, while groupⅠ received epidural anesthesia only. The primary assessment indexes, including VAS of wound rest pain and uterine contraction pain at different point time（6 h, 12 h, 18 h,24 h, 36 h postoperative） as well as the rate of seed pressing therapy and other adverse events, were observed and compared. Results There was no statistically significant difference in epidural dosage at different point time postoperative.There was no statistically significant difference in VAS of rest pain, while VAS of uterine contraction pain had significant difference at postoperative 12 h, 18 h, 24 h, 36 h between two groups（P = 0.019, 0.019, 0.005 and 0.001）. The first exhaust time in groupⅡ after operation was significantly earlier than that in groupⅠ [（25.88±10.94）h vs.（33.29±14.51）h,P = 0.04]. There were no severe adverse events in both groups. Conclusion Auricular point therapy combined with epidural anesthesia for postoperative analgesia of cesarean section can further reduce uterine contraction pain and promote the recovery of gastrointestinal function.