摘要
目的研究腹横肌平面阻滞联合舒芬太尼静脉自控镇痛对剖宫产术后镇痛的效果及促进快速康复效果。方法采用临床随机对照研究,选取2021年1月-2021年6月在乌鲁木齐市妇幼保健院进行剖宫产术的50例产妇作为研究对象,将产妇随机分为试验组和对照组,各25例。试验组(T组)术毕实施双侧腹横肌平面阻滞+静脉舒芬太尼自控镇痛,对照组(C组)仅使用静脉舒芬太尼自控镇痛。比较两组产妇的镇痛效果、48 h舒芬太尼累计用量、自控镇痛按压的次数、相关不良反应及快速康复的效果。结果静息状态和运动状态下的2 h和48 h的VAS评分差异无统计学意义(P>0.05),但4 h、8 h、12 h、24 h的VAS评分,T组明显低于C组(P<0.05);快速康复方面:胃肠排气、尿管拔除、术后坐起、离床活动、病区行走和初乳时间比较差异,T组均短于C组(P<0.05);两组术后均无尿潴留、呼吸抑制等严重并发症发生,但T组的恶心、便秘的发生率明显低于C组(P<0.05),T组舒芬太尼的总用量少于C组(59.58±10.81 vs 89.28±12.56,P<0.01)。结论腹横肌平面阻滞联合舒芬太尼静脉自控镇痛的多模式复合镇痛的效果优于单一使用舒芬太尼静脉镇痛,并能减少术后不良反应,促进产妇快速康复。
Objective To explore the effect of transversus abdominis plane block combined with sufentanil intravenous self-administered analgesia on analgesia after cesarean section and to promote rapid recovery.Methods In this randomized controlled clinical study,50 cases of lying-in-women who underwent cesarean section in maternal and child health hospitalof Urumqi from January 2021 to June 2021 were selected as the research objects,and they were randomly divided into experimental group and control group,with 25 cases in each group.The experimental group(group T)received bilateral transversal muscle blockcombined with intravenous sufentanil controlled analgesia after surgery,while the control group(group C)only received intravenous sufentanil controlled analgesia.The analgesic effect,the cumulative amount of sufentanil at 48 hours,the number of self-controlled analgesic compression,related adverse reactions and the effect of rapid recovery were compared between the two groups.Results There was no statistically significant difference in the VAS scores at 2 h and 48 h in the resting state and exercise state(P>0.05),but the VAS scores at 4 h,8 h,12 h and 24 h in the group Twere significantly lower than those in thegroup C(P<0.05).In terms of rapid recovery,gastrointestinal exhaust,catheter extraction,postoperative sitting up,out of bed,time,walking and colostrum time were shorter ingroup T than ingroup C(P<0.05).No serious postoperative complications such as urinary retention or respiratory depression occurredin either group.The incidence of nausea and constipation ingroup T was significantly lower than that ingroup C(P<0.05),and the total dosage of sufentanil ingroup T was less than that ingroup C(59.58±10.81 vs 89.28±12.56,P<0.01).Conclusion The multimodal combination of transversus abdominis plane block combined with sufentanil intravenous self-administered analgesia is more effective than single use of sufentanil intravenous analgesia and can reduce postoperative adverse effects and promote rapid maternal recovery.
作者
郭娟
张龙堂
林丽
GUO Juan;ZHANG Longtang;LIN Li(Maternal and Child Health Hospital of Urumqi,Urumqi,830000,China)
出处
《新疆医学》
2023年第5期533-537,共5页
Xinjiang Medical Journal
基金
新疆维吾尔自治区自然科学基金(项目编号:2019D01A19)
