浅析左旋布比卡因腹横肌平面阻滞在剖宫产术后镇痛的应用观察.docVIP

精品论文 参考文献 浅析左旋布比卡因腹横肌平面阻滞在剖宫产术后镇痛的应用观察 大庆油田总医院 163000 摘要：目的 浅析左旋布比卡因腹横肌平面阻滞在剖宫产术后镇痛的应用效果。方法此次研究的对象是选择ASAⅠ～Ⅱ级，择期在腰硬联合麻醉下行剖宫产手术产妇100例，将其临床资料进行回顾性分析，并随机分为A组和B组各50例。两组术后均在超声引导下行双侧腹横肌平面阻滞（TAP），A组注入0.25%左旋布比卡因20 ml，B组注入与A组等量的生理盐水。所有产妇术后均使用静脉自控镇痛泵（PCIA）进行术后镇痛，采用视觉模拟评分法（VAS）评价，比较两组术后4 h、8 h、12 h、24 h的VAS评分及镇痛效果、镇痛泵按压次数。结果A组术后4 h、8 h、12 h、24 h的VAS评分显著低于B组（Plt;0.01），A组术后镇痛满意度为84.0%（42/50），B组术后镇痛满意度为58.0%（29/50），A组术后镇痛满意度显著高于B组（Plt;001）。A组术后镇痛泵按压次数为（12.3plusmn;3.6）次，B组术后镇痛泵按压次数为（35.4plusmn;7.8）次， A组术后镇痛泵按压次数显著少于B组（Plt;0.01）。两组患者均未发现与术后镇痛相关的不良反应。结论超声引导下左旋布比卡因腹横肌平面阻滞用于剖宫产术后镇痛安全、有效，镇痛效果好，能减少静脉镇痛药的使用量。 关键词：左旋布比卡因；超声引导；腹横肌平面阻滞；剖宫产术后镇痛 [Abstract] Objective To analyze the application effect of levobupivacaine transversus abdominis plane block analgesia after cesarean section. Methods the study subjects were selected ASA I ~ II， elective in the combined spinal epidural anesthesia cesarean section maternal 100 cases， the clinical data were retrospectively analyzed， and were randomly divided into A group and B group， each of 50 cases. After operation in two groups were under ultrasound guidance underwent bilateral transversus abdominis plane block（TAP）， a group of injection of 0.25% levobupivacaine 20 ml， group B injected with a group of equal amounts of saline. All women after using patient-controlled intravenous analgesia（PCIA）for postoperative analgesia， using a visual analogue scale（VAS）evaluation， were compared between the two groups after 4 h， 8 h， 12 h， 24 h vas and analgesic effect， analgesia pump pressing times. Results in group A after 4 h， 8 h， 12 h， 24 h VAS score was significantly lower than that of group B（P lt; 0.01）. After operation in group a patient satisfaction was 84.0%（42 / 50）， after operation in group B analgesic satisfaction for 58.0%（29/50）. After operation in group a analgesic satisfaction significantly higher than in group B（P lt; 0 01）. After operation， the number of pressing times of the A group was（12.3 + 3.6）times， the number of times of the B group was（