超声引导下不同入路腰方肌阻滞对剖宫产术后产妇PCIA有效按压次数的影响

Impact of Different Approaches of Quadratus Lumbago Block on Effective PCIA Pressing Times for Parturient Women After Cesarean Section

目的探讨超声引导下不同入路腰方肌阻滞(QLB)对剖宫产术后产妇PCIA有效按压次数的影响。方法选取剖宫产产妇120例,随机分为四组各30例。在超声引导下,Q1组行前路QLB,Q2组行后路QLB,Q3组行侧路QLB,对照组不行QLB,比较四组产妇的VAS评分、PCIA有效按压次数及不良反应。结果术后12 h、24 h、48 h,Q1组、Q2组与Q3组的VAS评分低于对照组(P<0.05);术后12 h、24 h,Q2组的VAS评分低于Q1组与Q3组(P<0.05)。Q1组、Q2组与Q3组的PICA有效按压次数少于对照组(P<0.05),且Q2组少于Q1组与Q3组(P<0.05)。Q1组、Q2组与Q3组的不良反应发生率无统计学差异(P>0.05),但Q1组、Q2组与Q3组的不良反应发生率低于对照组(P<0.05)。结论剖宫产术后使用超声引导下QLB可有效降低产妇的PCIA有效按压次数,具有良好的镇痛效果与安全性,同时后路QLB的镇痛效果优于前路与侧路QLB。

Objective To explore the impact of different approaches of quadratus lumbago block(QLB)on effective PCIA pressing times for parturient women after cesarean section.Methods 120 parturient women with cesarean section were selected and randomly divided into four groups,with 30 cases in each group.Under the guidance of ultrasound,group Q1 received anterior QLB,group Q2 received posterior QLB,and group Q3 received lateral QLB;The control group did not receive QLB.The VAS score,effective PCIA pressing times and adverse reactions were compared among four groups.Results At 12 h,24 h and 48 h after surgery,group Q1,group Q2 and group Q3 had lower VAS score than the control group(P<0.05);At 12 h and 24 h after surgery,group Q2 had lower VAS score than group Q1 and group Q3(P<0.05).Group Q1,group Q2 and group Q3 had less times of effective PCIA pressing than the control group(P<0.05),and group Q2 had less times than group Q1 and group Q3(P<0.05).No statistical difference was found in the incidence of adverse reactions among group Q1,group Q2 and group Q3(P>0.05),but group Q1,group Q2 and group Q3 had lower incidence of adverse reactions than control group(P<0.05).Conclusions Ultrasound-guided QLB after cesarean section can effectively reduce the number of effective PCIA compressions of parturient women,and has good analgesic effect and safety.Meanwhile,posterior QLB has better analgesic effect than anterior and lateral QLB.