超声引导下经腹横筋膜平面阻滞联合髂腹下-髂腹股沟神经阻滞对剖宫产术后镇痛效果及安全性的影响

Effect of ultrasound-guided trans-abdominal transverse fascia plane block combined with iliohypogastric-ilioinguinal nerve block on analgesic effect and safety after cesarean section

目的探讨超声引导下经腹横筋膜平面阻滞联合髂腹下-髂腹股沟神经阻滞对剖宫产术后镇痛效果及安全性的影响。方法选取2018年1月至2020年1月收治的78例行剖宫产术患者,以数字表法将其随机分为对照组和观察组,各39例。两组均实施腰硬联合麻醉,对照组采用单纯经腹横筋膜平面阻滞,观察组则采用超声引导下经腹横筋膜平面阻滞联合髂腹下-髂腹股沟神经阻滞。比较两组术后镇痛效果及安全性。结果术后6、12、24 h,观察组的VAS评分显著低于对照组(P<0.05)。手术后,观察组的催乳素水平高于对照组(P<0.05)。两组的不良反应总发生率无显著差异(P>0.05)。结论超声引导下经腹横筋膜平面阻滞联合髂腹下-髂腹股沟神经阻滞有助于提高剖宫产术后镇痛效果,且不会明显增加不良反应,安全性高,值得推广。

Objective To investigate the effect of ultrasound-guided trans-abdominal transverse fascia plane block combined with iliohypogastric-ilioinguinal nerve block on analgesic effect and safety after cesarean section.Methods From January 2018 to January 2020,78 cases of cesarean section patients were randomly divided into control group and observation group by digital table method,with 39 cases in each group.Both groups were given combined spinal-epidural anesthesia,the control group underwent simple trans-abdominal transverse fascia plane block,while the observation group underwent ultrasound-guided trans-abdominal transverse fascia plane block combined with iliohypogastric-ilioinguinal nerve block.The analgesic effect and safety of the two groups were compared.Results At 6,12 and 24 h after operation,the VAS score of the observation group were significantly lower than those of the control group(P<0.05).After operation,the prolactin level of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Ultrasound-guided trans-abdominal transverse fascia plane block combined with iliohypogastric-ilioinguinal nerve block can help improve the analgesic effect after cesarean section without significantly increasing adverse reactions,with high safety,which is worthy of promotion.