超声引导下双侧腹横筋膜平面阻滞联合全身麻醉在高危剖宫产中的应用研究

Application research of ultrasound-guided bilateral transabdominal fascial plane block combined with general anesthesia in high-risk cesarean section

目的探讨超声引导下双侧腹横筋膜平面阻滞联合全身麻醉在高危剖宫产中的应用效果。方法 80例高危剖宫产产妇,按照随机数字表法分为观察组和对照组,每组40例。两组均行全身麻醉,并在超声引导下行双侧腹横筋膜平面阻滞,观察组注入0.375%罗哌卡因,对照组注入等量生理盐水。比较两组术前及术后收缩压(SBP)、平均动脉压(MAP)、心率(HR)变化,记录新生儿1、5、10 min的Apgar评分及分娩时间。结果术前,两组产妇的HR、MAP、SBP水平比较,差异均无统计学意义(P>0.05);术后,对照组产妇的HR、MAP、SBP水平均上升,观察组产妇的HR、MAP、SBP水平均降低,但与本组术前比较,差异均无统计学意义(P>0.05);两组术后的HR、MAP、SBP水平比较,差异均具有统计学意义(P<0.05)。两组新生儿1、5、10 min Apgar评分及分娩时间比较,差异均无统计学意义(t=0.515、1.436、1.526、0.943,P>0.05)。结论超声引导下双侧腹横筋膜平面阻滞联合全身麻醉在高危剖宫产中可降低产妇血压及HR,并不能完全改善胎儿Apgar评分。

Objective To investigate the application effect of ultrasound-guided bilateral transabdominal fascial plane block combined with general anesthesia in high-risk cesarean section. Methods Eighty parturients with high-risk cesarean section were divided into observation group and control group according to the random number table method, 40 cases in each group. The two groups received general anesthesia and ultrasound-guided bilateral transabdominal fascial plane block. The observation group received 0.375% Ropivacaine and the control group received the same amount of Saline. The changes of systolic blood pressure（SBP）, mean arterial pressure（MAP） and heart rate（HR） between the two groups before and after surgery were observed. The neonatal Apgar score at 1, 5 and 10 min after birth and delivery time were recorded. Results Before surgery, there were no significant differences in the levels of HR, MAP and SBP of parturients between the two groups（P〉0.05）. After surgery, the levels of HR, MAP and SBP in the control group increased, the levels of HR, MAP and SBP in the observation group decreased, but there were no significant differences compared with those before surgery（P〈0.05）. The differences were statistically significant in the HR, MAP and SBP levels between the two groups（P〈0.05）. There were no significant differences in the neonatal Apgar scores at 1, 5, and 10 min after birth and delivery time between the two groups（t=0.515, 1.436, 1.526, 0.943, P〉0.05）. Conclusion Th application of ultrasound-guided bilateral transabdominal fascial plane block combined with general anesthesia in high-risk cesarean section can reduce the blood pressure and HR of parturients, and can not completely improve the neonatal Apgar score.