摘要
目的评价腹横肌平面(TAP)阻滞在肥胖产妇行剖宫产手术的镇痛效果。方法选取2019年1月至2020年6月于阳江市人民医院行剖宫产手术的肥胖产妇共50例,随机分为处理组和对照组,每组25例,处理组术前应用超声引导下腹横肌平面阻滞,每侧注射0.375%的罗哌卡因20 ml,对照组常规治疗;对比两组产妇术后24 h、48 h通过自控静脉镇痛给予的舒芬太尼剂量,记录初次追加镇痛的时间,对比两组术后不同时间点的疼痛评分、Ramsay镇静和BCS舒适度评分,记录两组的不良反应。结果处理组自控静脉镇痛中24 h、48 h的舒芬太尼用量显著少于对照组,差异具有统计学意义(P<0.01);处理组术后首次追加镇痛时间显著大于对照(P<0.01),且处理组术后4 h、8 h、12 h、24 h和48 h其静息及活动时的疼痛VAS评分均显著低于对照组(P<0.05),处理组术后12 h和24 h的BCS舒适度评分显著高于对照组,差异具有统计学意义(P<0.001)。两组术后的Ramsay镇静和PONV评分对比差异无统计学意义(P>0.05)。结论TAP阻滞在肥胖产妇行剖宫产术具有良好的镇痛效果,能显著提高产妇的术后舒适度,安全性良好。
Objective To evaluate the analgesic effect of transverse abdominal plane(TAP)block in obese women undergoing cesarean section.Methods A total of 50 obese women who underwent cesarean section at Yangjiang People’s Hospital from January 2019 to June 2020 were selected and randomly divided into treatment group and control group,25 cases in each group.The treatment group was treated with ultrasound-guided lower transversus abdominis plane block before operation,and 0.375%ropivacaine 20 ml was injected on each side.The control group was given conventional treatment.Comparing the doses of sufentanil given by patient-controlled epidural analgesia at 24 h and 48 h after operation between the two groups of parturients,recording the time of initial supplementary analgesia,and comparing the pain scores,Ramsay sedation and BCS comfort of the two groups at different time points after surgery Score,record the adverse reactions of the two groups.Results The amount of sufentanil in 24 h and 48 h in patientcontrolled epidural analgesia in the treatment group was significantly less than that in the control group,and the difference was statistically significant(P<0.01);The first additional analgesia time in the treatment group was significantly longer than that in the control group(P<0.01),and 4 h,8 h,12 h,24 h and 48h postoperative pain VAS scores of the treatment group were significantly lower than those of the control group(P<0.05).The BCS comfort scores of the treatment group at 12 h and 24 h after surgery were significantly higher than those of the control group,and the difference was statistically significant(P<0.001).There was no statistically significant difference in Ramsay sedation and PONV scores between the two groups(P>0.05).Conclusions TAP block has a good analgesic effect in obese women undergoing cesarean section,can significantly improve the postoperative comfort of the women,and has good safety.
作者
刘春华
黎达锋
Liu Chunhua;Li Dafeng(Department of Anesthesiology,Yangjiang People's Hospital,Affiliated to Guangdong Medical University,Yangjiang 529500,China)
出处
《中华肥胖与代谢病电子杂志》
2020年第3期180-184,共5页
Chinese Journal Of Obesity and Metabolic Diseases:Electronic Edition
关键词
腹横肌平面阻滞
肥胖
产妇
剖宫产
镇痛
舒适度
Transverse abdominal plane block
Obesity
Parturient
Cesarean section
Analgesia
Comfort