超声引导腰方肌阻滞与腹横肌阻滞在剖宫产术后镇痛效果的随机对照研究被引量：23

Randomized controlled study of postoperative anesthetic efficacies between ultrasound-guided quadratuslumborum block and transversus abdominis plane block for cesarean section

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摘要目的对比超声引导双侧腰方肌阻滞(QLB)与双侧腹横肌阻滞(TAP)在剖宫产术后镇痛的效果。方法选取行剖宫产的产妇共70例,按随机数字法分为QLB组和TAP组,每组35例,QLB组术前采用超声引导下腰方肌阻滞,每侧0.3%罗哌卡因共20 mL,TAP组则采用超声引导下腹横肌阻滞,每侧0.3%罗哌卡因共20 mL,对比两组产妇术后24 h舒芬太尼使用总量,对比两组术后首次追加镇痛的时间,比较两组术后2、4、8、12、24和48 h静息和运动时的疼痛VAS评分,对比不同时间的Ramsay镇静评分和BCS(Bruggrmann comfort scale)舒适度评分,并记录两组产妇的不良反应。结果QLB组产妇其术后24 h舒芬太尼用量显著低于TAP组,差异有统计学意义(P<0.05),而QLB组产妇其术后首次追加镇痛时间显著高于TAP组(P<0.05),且QLB组在术后2、4、8、12和24 h的静息和活动时的疼痛VAS评分均显著低于TAP组(P<0.05),两组产妇在术后2、12和24 h的Ramsay镇静评分对比差异无统计学意义(P>0.05),而QLB组在术后2和12 h的BCS舒适度评分显著高于TAP组(P<0.05),两组术后的平均恶心呕吐评分对比差异无统计学意义(P>0.05)。结论QLB阻滞在剖宫产的镇痛效果显著优于TAP阻滞,临床安全性良好。

作者蔡日生廖美娟仲吉英黄振兴张涛 CAI Ri-sheng;LIAO Mei-juan;ZHONG Ji-ying;HUANG Zhen-xing;ZHANG Tao

机构地区佛山市第一人民医院麻醉科

出处《广东医学》 CAS 2019年第21期3084-3087,共4页 Guangdong Medical Journal

基金佛山市卫生和计划生育局医学科研立项项目(编号:20170058)

关键词腰方肌阻滞腹横肌阻滞剖宫产镇痛效果

分类号 R614 [医药卫生—麻醉学] R719 [医药卫生—妇产科学]

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