甲强龙联合罗哌卡因用于超声引导II/IH在剖宫产术后镇痛中的效果

Efficacy of ultrasound-guided Ilioinguinal and Iliohypogastric blocks with methylprednisolone and ropivacaine for analgesia after Cesarean section

目的:观察甲强龙混合罗哌卡因用于超声导引的髂腹下/髂腹股沟神经阻滞(iloinguinal/iliohypogastric nerve block,II/IH)在剖宫产术后镇痛的效果。方法:入选的产妇分成3组,A组II/IH予罗哌卡因、B组II/IH予甲强龙0. 5 mg/kg混合罗哌卡因、C组II/IH予甲强龙1 mg/kg复合罗哌卡因,患者均接受双侧II/IH,患者静脉镇痛泵的配方相同,记录术后6 h、12 h、24 h、36 h和48 h的镇痛药物使用情况,记录不良反应发生情况。结果:对比单纯罗哌卡因组,混合甲强龙可以减低患者的PCIA按压次数、额外镇痛药物需求量、恶心/呕吐次数(P <0. 05)。结论:对于剖宫产术患者,超声引导II/IH可获得满意镇痛,且混合甲强龙可减少恶心、呕吐发生。

Objective： To investigate the efficacy of ultrasound-guided Ilioinguinal and Iliohypogastric（ II/IH） blocks with methylprednisolone and ropivacaine for analgesia after Cesarean section. Methods： Patients were divided into three groups,ropivacaine group（ Group A）,methylprednisolone 0. 5 mg. kg-1 and 0. 4% ropivacaine group（ group B） and methylprednisolone 1 mg. kg-1 and 0. 4 % ropivacaine group（ group C）. All patients received the ultrasound-guided bilateral II/IH,and the formula of intravenous analgesia pump was the same in the patients. The consumption of drugs was recorded at 6,12,24,36 and 48 h after surgery. The adverse reactions were also recorded. Results： Compared with group A,the press times of patient-controlled intravenous analgesia（ PCIA）,additional analgesic drug requirements and occurrence of nausea and vomiting were significantly decreased at each time point in group B and group C（ P 〈 0. 05）. Conclusion： The ultrasound-guided II/IH blocks with methylprednisolone and ropivacaine can provide the satisfied analgesia with lower incidence of nausea and vomiting for patients after Cesarean section.