左旋布比卡因腹横肌平面阻滞在剖宫产术后镇痛应用.docVIP

左旋布比卡因腹横肌平面阻滞在剖宫产术后镇痛应用 　　【摘要】目的研究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，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（P0.01），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（P001）。A组术后镇痛泵按压次数为（12.3±3.6）次，B组术后镇痛泵按压次数为（35.4±7.8）次， A组术后镇痛泵按压次数显著少于B组（P0.01）。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 　　中图分类号：R719.8 文献标识码：ADOI：10.3969/j.issn2015.04.023 　　【Abstract】ObjectiveTo explore application effect of levobupivacaine transversus abdominis plane（TAP） block for postoperative analgesia in cesarean section.Methods100 delivery women with ASAⅠ～Ⅱundergoing selective cesarean section under combined spinal epidural anesthesia（CSEA） were randomly divided into group A and group B，with 50 cases in each group.Both groups received bilateral TAP block under ultrasonic guidance after surgery.The group A were injected with 20 ml of 0.25% levobupivacaine，while the group B were given the same amount of normal saline with the group A.Patient controlled intravenous analgesia（PCIA） was used for postoperative analgesia in all cases.Visual Analogue Scale（VAS）was used to evaluate therapeutic effect.VAS scores 4，8，12 and 24 hours after surgery，analgesic effect，pressing numbers of PCIA were compared between groups.Results VAS scores 4，8，12 and 24 hours after surgery of the group A were significantly lower than those of the group B（P0.01）.Satisfaction degree of postoperative analgesia of the group A was 84.0%（42/50） and that of the group B was 58.0%（29/50），so the former were significantly higher than the latter （P0.01）.Pressing numbers of PCIA of the group A was（12.3±3.6）times and those of the group B was（35.4±7.8）times，the former was significantly fewer than the latter （P0.01）.No side effects of postoperative analgesia were