摘要
目的:比较超声引导下腰方肌阻滞与腹横肌阻滞在剖宫产产妇术后镇痛中的应用效果。方法:回顾性分析2020年5月至2022年5月该院收治的105例剖宫产产妇的临床资料,根据麻醉方法不同将其分为对照组(n=52)和观察组(n=53)。对照组行超声引导下腹横肌阻滞,观察组行超声引导下腰方肌阻滞。比较两组麻醉效果、术后不同时间(术后2、6、12、24 h)疼痛程度[视觉模拟评分法(VAS)]评分、术后不同时间(术后即刻、术后24 h)氧化应激指标[皮质醇(Cor)、内皮素(ET)、去甲肾上腺素(NE)]水平、术后临床恢复时间和并发症发生率。结果:观察组镇痛起效时间短于对照组,镇痛持续时间长于对照组,布托啡诺用量少于对照组,镇痛补救率低于对照组,差异均有统计学意义(P<0.05);术后2、6、12、24 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);术后24 h,两组血清Cor、NE、ET水平均高于术后即刻,但观察组低于对照组,差异有统计学意义(P<0.05);观察组首次排气时间、首次下床活动时间、初乳时间均短于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下腰方肌阻滞应用于剖宫产产妇,可提高麻醉效果,减轻术后疼痛和氧化应激反应,促进术后恢复,效果优于超声引导下腹横肌阻滞。
Objective:To compare application effects of ultrasound-guided quadratus lumborum block and transversus abdominis block in postoperative analgesia of parturients with cesarean section.Methods:The clinical data of 105 parturients with cesarean section admitted to the hospital from May 2020 to May 2022 were retrospectively analyzed.According to different anesthesia methods,they were divided into control group(n=52)and observation group(n=53).The control group underwent ultrasound-guided transversus abdominis block,while the observation group underwent ultrasound-guided quadratus lumborum block.The anesthetic effects,the pain degree[visual analogue scale(VAS)]scores at different time points after the surgery(2,6,12,24 h after the surgery),the oxidative stress index[cortisol(Cor),endothelin(ET),norepinephrine(NE)]levels at different time points after the surgery(immediately after the surgery,24 h after the surgery),the postoperative clinical recovery time,and the incidence of complications were compared between the two groups.Results:The onset time of analgesia in the observation group was shorter than that in the control group,the duration of analgesia was longer than that in the control group,the dosage of Butorphanol was less than that in the control group,the rescue rate of analgesia was lower than that in the control group,and the differences were statistically significant(P<0.05).At 2,6,12 and 24 h after the surgery,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).At 24 h after the surgery,the levels of serum Cor,NE and ET in the two groups were higher than those immediately after the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The first exhaust time,the first ambulation time and the colostrum time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Ultrasound-guided quadratus lumborum block applied to the parturients with cesarean section can improve the anesthetic effects,reduce the postoperative pain and the oxidative stress,and promote the postoperative recovery.Moreover,it is superior to ultrasound-guided transverse abdominal muscle block.
作者
刘殿文
LIU Dianwen(Department of Anesthesiology of Shangqiu Maternal and Child Health Hospital,Shangqiu 476000 Henan,China)
出处
《中国民康医学》
2024年第4期147-150,共4页
Medical Journal of Chinese People’s Health
关键词
超声引导
腰方肌阻滞
腹横肌阻滞
剖宫产
疼痛
氧化应激
Ultrasound guidance
Quadratus lumborum block
Transversus abdominis block
Cesarean section
Pain
Oxidative stress
