艾司氯胺酮在剖宫产腹横肌平面阻滞中的应用效果

Application effect of Esketamine in transversus abdominis plane block during cesarean section

目的观察艾司氯胺酮在剖宫产腹横肌平面阻滞(TAPB)中的应用效果。方法选取2023年8月至2024年3月青岛大学附属医院收治的60例剖宫产产妇作为研究对象,采用随机数字表法分为观察组与对照组,每组各30例。观察组采用0.375%罗哌卡因+15 mg艾司氯胺酮20 ml行TAPB,对照组采用0.375%罗哌卡因20 ml行TAPB,两组均使用患者自控静脉镇痛泵(PCIA)。比较两组疼痛评分、术后48 h PCIA使用情况及不良反应发生情况。结果观察组术后6、8、12 h的视觉模拟评分法评分均低于对照组(P<0.05)。观察组术后首次按压PCIA时间长于对照组,有效按压PCIA次数少于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论艾司氯胺酮在剖宫产TAPB中应用可延长镇痛时间,减少PCIA的使用,且不增加不良反应。

Objective To observe the application effect of Esketamine in transversus abdominis plane block(TAPB)during cesarean section.Methods A total of 60 parturients who underwent cesarean section admitted to the Affiliated Hospital of Qingdao University from August 2023 to March 2024 were selected as the study objects.All the parturients were divided into the observation group and the control group using the random number table method,with 30 cases in each group.The observation group received 0.375%Ropivacaine+15 mg Esketamine 20 ml for TAPB,and the control group received 0.375%Ropivacaine 20 ml for TAPB.Both groups received patient controlled intravenous analgesia(PCIA).The pain score,postoperative 48 hours PCIA usage,and the incidence of adverse reactions were compared between the two groups.Results The visual analogue scale scores at 6,8,and 12 hours after operation of the observation group were lower than those of the control group(P<0.05).The time of first pressing PCIA after operation in the observation group was longer than that in the control group,and the number of effective pressing PCIA was fewer than that in 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 The application of Esketamine in TAPB during cesarean section can prolong the analgesic time,reduce the use of PCIA,and does not increase adverse reactions.