超声引导后入路和侧入路腹横肌平面阻滞对剖宫产术后镇痛的影响

Effect of Ultrasound-Guided Transversus Abdominis Plane Block through Posterior and Lateral Approaches on Analgesia after Cesarean Section

目的:探讨超声引导后入路和侧入路腹横肌平面阻滞(TAP)对剖宫产术后的镇痛效果。方法:选取2019年1月~2021年1月在本院行剖宫产手术的产妇122例,采用数字表法随机分为观察组(后入路法TAP阻滞)和对照组(侧入路法TAP阻滞),每组各61例。对比两组术后不同时间点静息和运动状态下的疼痛视觉模拟评分(VAS);记录两组镇痛效果及术后24 h的镇痛满意度。结果:观察组术后6 h、12 h运动状态下VAS评分均明显低于对照组(均P<0.05)。观察组镇痛药物浓度达到峰值的时间显著短于对照组,而术后48内下床活动总时间显著长于对照组(均P<0.05)。观察组术后镇痛满意度评分高于对照组(P<0.05)。结论:后入路法TAP阻滞相比于侧入路法TAP阻滞镇痛效果更好,产妇术后镇痛满意度更高。

Objective:To explore the effect of ultrasound-guided transversus abdominis plane(TAP)block through posterior and lateral approaches on analgesia after cesarean section.Methods:A total of 122 puerpera underwent cesarean section between January 2019 and January 2021 in our hospital were enrolled.According to random number table method,they were divided into the observation group(TAP block through posterior approach)and the control group(TAP block through lateral approach),with 61 cases in each group.The scores of visual analogue scale(VAS)at rest state and motion state were compared between the two groups at different time points after surgery.The analgesic effect and analgesia satisfaction at 24 h after surgery were evaluated.Results:VAS scores at motion state in the observation group were significantly lower than those in control group at 6 h and 12 h postoperative(both P<0.05).The time of analgesic drug concentration up to peak in the observation group was significantly shorter,and the total ambulation time within 48 h postoperative was significantly longer,when compared to the control group(both P<0.05).The satisfaction of postoperative analgesia in the observation group was higher than that in the control group(P<0.05).Conclusion:Compared to the lateral approach,ultrasound-guided TAP block through posterior approach has better analgesic effect and higher satisfaction of postoperative analgesia.