超声引导下双侧TAP阻滞对产妇血清儿茶酚胺泌乳素水平及血流动力学的影响

Effect of Ultrasound-guided TAP Block on Serum Catecholamine,Prolactin Level and Hemodynamics of Puerpera After Cesarean Section

目的探讨超声引导下TAP阻滞对剖宫产术后产妇血清儿茶酚胺(CA)、泌乳素(PRL)水平及血流动力学的影响。方法选择我院2017年1月至2017年12月收治的1 00例剖宫术产妇,随机数字表法分为对照组与研究组,均由同1名副主任医师行超声引导下双侧TAP阻滞,实验组TAP阻滞给予0.2%盐酸罗哌卡因注射液每侧20 ml,对照组每侧给予生理盐水20 ml,两组术后均接未开放的静脉PCI镇痛泵(配方:羟考酮1 mg/ml以生理盐水稀释至100 ml),术后静态VAS评分2分时开放的静脉PCI镇痛泵并给予1次blous。观察并比较两组治疗前后血清多巴胺、去甲肾上腺素、肾上腺素、PRL、心率及平均动脉压水平的变化,镇痛效果及不良反应的发生情况。结果手术后,两组血清多巴胺、去甲肾上腺素、肾上腺素、PRL、心率、平均动脉压(MAP)、VAS水平均较手术前显著上升,实验组上述指标均低于对照组(P<0.05);实验组开放静脉镇痛泵时间明显晚于对照组(P<0.05),实验组不良反应发生率显著低于对照组(P<0.05)。结论超声引导下双侧TAP阻滞在剖宫产术后镇痛效果确切,对产妇术后CA的分泌能较好抑制,并且对泌乳作用和血流动力学的影响较小。

Objective To investigate the effects of the ultrasound-guided TAP block on the serum levels of catecholamine,prolactin and hemodynamics and lactation of patients after the cesarean section maternal.Methods 100 patients of cesarean section maternal from January 2017 to December 2017 were selected and according to different analgesia methods,the patients were divided into the control group and the research group.Then the dopamine,norepinephrine,epinephrine,plasma PRL,visual analogue scale(VAS),heart rate,mean arterial pressure(MAP),and incidence of adverse reactions were observed and compared between the two groups before and after the treatment.Results After surgery,the dopamine,norepinephrine,epinephrine,plasma PRL,heart rate,MAP and VAS in the two groups were significantly lower than before,and the research group was significantly lower than that of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference about the incidence of adverse reactions between the two groups(P>0.05).Conclusion The effect of TAP block in postoperative analgesia is certain,which can inhibit the secretion of maternal CA level,and less impact on lactation and hemodynamics.