浅析左旋布比卡因腹横肌平面阻滞在剖宫产术镇痛的应用.docVIP

浅析左旋布比卡因腹横肌平面阻滞在剖宫产术镇痛的应用 大庆油田总医院163000 【摘要】目的探讨并分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ASA I?1[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、8h、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、8h、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)o 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 (Pt;0.01)o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 investigate and analyze the application effect of levobupivacai ne tra nsversus abdomi nis plane block an algesia after cesarea n section.Methods the study subjects were selected ASA I ~ II, elective in the combined spinal epidural anesthesia cesarean section maternal 100 cases 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.AII women after using patient-controlled in trave nous an algesia (PCIA) for postoperative an algesia, using a visual an alogue scale (VAS) evaluation, were compared between the two groups after 4 h, 8h， 12 h, 24 h vas and an algesic effect, analgesia pump pressi ng 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 an algesic satisfacti on significa ntly higher tha n 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 nu mber of times of the B group was (35.4 + 7.8), the nu mb