摘要
目的评价罗哌卡因腹横肌平面(TAP)阻滞用于剖宫产术后镇痛的临床效果。方法选择择期在腰麻下行剖宫产术的产妇90例,采用随机数字表法分为3组(n=30):生理盐水组(A组)、0.20%罗哌卡因组(B组)和0.25%罗哌卡因组(C组)。B组和C组术毕均在超声引导下行双侧TAP阻滞,每一侧分别注入0.20%、0.25%罗哌卡因各20mL,而A组给予等容量生理盐水。同时使用经静脉患者自控镇痛(PCIA)。分别于术后2、4、8、12、24、48h各时点记录疼痛视觉模拟评分(VAS)、Ramsay镇静评分及舒适度(BCS)评分。记录产妇术后48h内PCIA中舒芬太尼用量、单次自控镇痛(PCA)平均按压次数、产妇镇痛总体满意度及TAP阻滞相关的不良反应发生率。结果与A组比较,B、C组术后不同时点VAS评分均降低(P<0.05),而BCS评分均升高(P<0.05);B、C组术后不同时点VAS评分及BCS评分比较,差异均无统计学意义(P>0.05)。与A组比较,B、C组术后48h内单次PCA平均按压次数及PCIA中舒芬太尼用量均减少(P<0.05),而术后48h内镇痛总体满意度升高(P<0.012 5)。3组产妇术后48h内均未发生TAP阻滞相关的不良反应。结论 0.20%及0.25%罗哌卡因TAP阻滞用于剖宫产产妇术后镇痛的临床效果均较好,且不良反应较少,安全性较高。
Objective To explore the effect of transversus abdominis plane block （TAP） with ropivacaine on clinical effi cacy of postoperative analgesia in puerpera undergoing cesarean section. Methods Ninety puerpera scheduled for cesarean sec- tion under spinal anesthesia were randomly divided into three groups （n-- 30 each） ： normal saline group （group A）, 0.20% ropivacaine group （group B） and 0.25% ropivacaine group （group C）. After surgery, ultrasound guided TAP block was per- formed in two sides, and 20 mL of 0.20% and 0.25% ropivacaine was injected respectively in each side in group B and group C, while ropivacaine was instead of normal saline at the same volume in group C. The three groups all received patient controlled in- travenous analgesia （PCIA） after operation. The score of visual analogue scale （VAS）, Ramsay sedation score and bruggemann comfort scale （BCS） score were evaluated respectively at 2, 4, 8, 12, 24 and 48 h after operation. The consumption of sufen- tanil in PC1A and the average press number of patient controlled analgesia （PCA） were both recorded within 48 h after opera- tion. The analgesic effect overall satisfaction of puerpera and adverse reactions associated with TAP block were also recorded within 48 h after operation. Results Compared with group A, VAS score were all lower （P〈0.05）, but BCS score were all higher （P〈0.05） at different time points after operation in group B and C. There was no statistically significant differences （all P〉0.05） in VAS score and BCS score at different time points after operation between group B and C. Compared with group A, the consumption of sufentanil in PCIA and the average press number of PCA were lower （both P〈0.05）, however, the analge- sic effect overall satisfaction of puerperal was higher （P〈0. 012 5） within 48 h after operation in group B and C. There was no adverse reactions associated with TAP block in the three groups. Conclusion TAP with ropivacaine at the concentrations of O. 20% and O. 25 % is effective and safe in postoperative analgesia after cesarean section, with less adverse reaction.
出处
《福建医药杂志》
CAS
2015年第4期74-77,共4页
Fujian Medical Journal
关键词
罗哌卡因
腹横肌平面阻滞
术后镇痛
剖宫产
ropivacaine
transversus abdominis plane block
postoperative analgesia
cesarean section
