腹直肌鞘神经阻滞在剖宫产术后镇痛中的应用效果

Application Effect of Rectus Abdominis Sheath Nerve Block in Postoperative Analgesia After Cesarean Section

目的:探讨腹直肌鞘神经阻滞在剖宫产术后镇痛中的应用效果。方法:选取2019年2月—2021年2月于贵阳市第四人民医院行剖宫产的74例产妇作为研究对象,根据随机抽签法分为对照组与研究组,各37例。两组产妇均采用相同的麻醉方式以及维持方案,术后应用相同的药物与相同参数的静脉自控镇痛泵。术毕,研究组在超声引导下行腹直肌鞘神经阻滞。比较两组麻醉效果。结果:研究组静息、活动状态不同时刻疼痛评分均低于对照组,差异有统计学意义(P<0.001)。研究组产后抑郁发生率低于对照组,差异有统计学意义(P=0.041)。麻醉后10、30、60 min时,两组白细胞介素-6、血浆血糖、皮质醇水平均高于麻醉前,但研究组均低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P=0.032)。结论:腹直肌鞘神经阻滞应用于剖宫产术后的效果显著,可有效镇痛,降低产妇疼痛程度,改善应激反应,安全性较高。

Objective:To explore the application effect of rectus abdominis sheath nerve block in postoperative analgesia after cesarean section.Methods:A total of 74 parturients who underwent cesarean section in the Fourth People’s Hospital of Guiyang from February 2019 to February 2021 were selected as the study subjects.According to the random drawing method,they were divided into control group and study group,with 37 cases each.Both groups received the same anesthesia and maintenance regimen,and the same postoperative drugs and the same parameters of intravenous patient-controlled analgesia pump.After the surgery,the study group performed rectus abdominis sheath nerve block under ultrasound guidance.The effects of anesthesia were compared between the two groups.Results:The pain scores at rest and during activity in the study group were lower than those in the control group,and the difference was statistically significant(P<0.001).The incidence of postpartum depression in the study group was lower than that in the control group,and the difference was statistically significant(P=0.041).At 10,30 and 60 min after anesthesia,the levels of interleukin-6,plasma blood glucose and cortisol in the two groups were higher than those before anesthesia,but the study group was lower than the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P=0.032).Conclusion:The rectus abdominis sheath nerve block has a significant effect after cesarean section,which can effectively relieve pain,reduce maternal pain degree,improve stress response,and have high safety.