多模式镇痛对剖宫产术后的疗效及满意度影响

Effect of multimodal analgesia on efficacy and satisfaction in patients after cesarean section

目的探讨剖宫产术后采用腹横肌平面阻滞联合硬膜外吗啡多模式镇痛的效果。方法选择剖宫产产妇100例,随机分为对照组和观察组各50例。观察组行腹横肌平面阻滞联合硬膜外吗啡多模式镇痛,对照组行单纯硬膜外吗啡镇痛。比较两组的视觉模拟评分法(VAS)评分、术后哺乳情况、满意度及不良反应情况。结果每组均成功入组47例。观察组术后12 h、48 h静息和运动时VAS评分低于对照组,差异有统计学意义(t分别=4.57、9.91、11.36、9.48,P均<0.05);观察组肠排气时间、初乳分泌时间均短于对照组,差异有统计学意义(t分别=4.28、5.07,P均<0.05);观察组镇痛满意度(97.87%)明显高于对照组(65.96%),不良反应发生率明显低于对照组,差异均有统计学意义(X^2分别=16.16、3.88,P均<0.05)。结论多模式镇痛可有效降低剖宫产术后患者疼痛程度,缩短初乳分泌时间,提高镇痛满意度及安全性。

Objective To explore the effect of multimodal analgesia on efficacy and satisfaction in patients after cesarean section.Methods A total of 100 patients with cesarean section were randomized into two groups with 50 cases in each.Patients in the control group received epidural morphine for post-operative analgesia while patients in the observation group received multimodal analgesia including epidural morphine and transversus abdominis plan block.The visual analogue scale(VAS)score,postoperative recovery,satisfaction and adverse reactions were compared between the two groups.Results Both group enrolled 47 patients finally.The VAS score at rest of the observation group was lower than that of the control group at 12 h and 48 h after operation as well as the VAS score at movement(t=4.57,9.91,11.36,9.48,P<0.05).The first intestinal exhaust time,colostrum secretion time were significantly earlier in the observation group(t=4.28,5.07,P<0.05).Compared with the control group,the patient satisfaction rate was higher in the observe group(97.87%vs 65.96%)and the adverse reactions incidence was significantly lower(χ^2=16.16,3.88,P<0.05).Conclusion Multimodal analgesia can improve post-operative analgesia after cesarean section,shorten the time of colostrum secretion,and improve the satisfaction and safety of analgesia.