超声引导下腹横肌平面阻滞对全麻剖宫产产妇术后疼痛、产后血栓前状态及泌乳素的影响

Effects of Ultrasound-Guided Lower Transverse Abdominal Muscle Plane Block on Pain after General Anesthesia and Cesarean Section, and Prethrombotic State and Prolactin

目的观察超声引导下腹横肌平面阻滞对全麻剖宫产产妇术后镇痛效果及对血栓前状态、泌乳素的影响。方法选择我院2019年1—12月全麻下行剖宫产产妇40例,按随机数字表法分为研究组与对照组(各20例),比较疼痛程度、舒适度、镇痛满意度、产后血栓前状态及泌乳素等。结果研究组术后6 h、12 h、24 h静息时VAS评分明显降低,术后6 h、12 h、24 h BCS评分明显升高(P<0.05)。研究组术后使用曲马多次数及剂量明显少于对照组(P<0.05)。两组术后TM明显下降,PF4显著升高(P<0.05);但两组术前、术后24 h泌乳素水平无明显差异(P>0.05)。结论超声引导下腹横肌平面阻滞可缓解全麻剖宫产产妇术后疼痛,提高产妇舒适度和满意度,且全麻后血栓前状态有明显变化,但对术后泌乳素分泌影响不大。

OBJECTIVE To observe the effect of ultrasound-guided lower transversusabdominis plane block on postoperative analgesia for parturients under general anesthesia and cesarean section and its influence on prethrombotic state and prolactin.METHODS From January 2019 to December 2019 in target hospital,40 cases of cesarean section under general anesthesia were selected and divided into a B-ultrasound group and a control group(20 cases each)according to the random number table.The degree of pain,comfort,satisfaction with analgesia,postpartum prethrombotic state and prolactin were compared.RESULTS In the B-ultrasound group,the VAS score at rest at 6 h,12 h,and 24 h after surgery were significantly reduced,and the BCS scores at 6 h,12 h,and 24 h after surgery were significantly increased(P<0.05).The frequency and dose of tramadol in the B-ultrasound group were significantly less than the control group(P<0.05).TM decreased significantly in these two groups after operation,and PF4 increased significantly(P<0.05).However,there was no significant difference in prolactin levels between these two groups before and after the operation(P>0.05).CONCLUSION Ultrasound-guided transversusabdominis plane block can relieve postoperative pain of puerpera during cesarean section under general anesthesia,improve maternal comfort and satisfaction.The prethrombotic state after general anesthesia had significant changes,but it had little effect on postoperative prolactin secretion.