摘要
目的 比较超声引导下腰方肌筋膜平面阻滞(QLB)与腹横肌筋膜平面阻滞(TAP)用于剖宫产术后的镇痛疗效。方法 纳入2018年4月至2020年4月在蛛网膜下腔阻滞下行剖宫产的患者76例,随机分为QLB组38例,TAP组38例。两组患者术后均给予静脉吗啡自控镇痛泵。观察术后48 h内各时间段的疼痛VAS评分、吗啡使用剂量以及相关并发症的发生率。结果 术后12 h,QLB组吗啡消耗量为(6.08±2.76)mg,TAP组为(7.97±3.22)mg;术后24 h,QLB组吗啡消耗量为(6.89±5.01)mg,TAP组为(14.12±6.76)mg;术后48 h,QLB组吗啡消耗量为(9.12±8.22)mg,TAP组为(18.07±9.86)mg,差异均有统计学意义(P=0.039、0.013、0.022)。术后24 h和48 h,TAP组患者的疼痛VAS评分高于QLB组(P<0.05),术后12 h内两组患者的疼痛VAS评分差异无统计学意义(P>0.05);TAP组出现眩晕、恶性呕吐的例数高于QLB组(P<0.05)。结论 对于剖宫产术后镇痛,超声引导下QLB在吗啡使用剂量、疼痛缓解以及并发症等方面优于TAP。
ObjectiveTo compare the analgesia efficacy of ultrasound-guided quadratus lumborum fascial plane block(QLB)and transverse abdominis fascial plane block(TAP)for post-cesarean section pain.MethodsA total of 76 patients,who underwent cesarean section under subarachnoid block between April 2018 and April 2020,were enrolled in this study.The patients were randomly divided into QLB group(n=38)and TAP group(n=38).After operation,intravenous morphine-controlled analgesia pump was employed in patients of both groups.The VAS pain score,the used dosage of morphine and the incidence of procedure-related complications within 48 hours after operation were recorded.ResultsIn QLB group and TAP group,the used dosage of morphine at 12 hours after cesarean section was(6.08±2.76)mg and(7.97±3.22)mg respectively,at 24 hours after cesarean section was(6.89±5.01)mg and(14.12±6.76)mg respectively,at 48 hours after cesarean section was(9.12±8.22)mg and(18.07±9.86)mg respectively,the differences between the two groups were statistically significant(P=0.039,P=0.013 and P=0.022 respectively).The postoperative 24-hour and 48-hour VAS pain scores of the TAP group were significantly higher than those of QLB group(P<0.05).No statistically significant differences in postoperative 12-hour VAS pain score existed between the two groups(P>0.05).The total number of patients who developed dizziness and severe vomiting in the TAP group was higher than that in the QLB group(P<0.05).ConclusionFor analgesia of post-cesarean section pain,ultrasound-guided QLB is superior to TAP in the morphine dosage,pain relief and complications.
作者
邵元媛
王宏娟
陈薇
朱秀娟
丰亮
SHAO Yuanyuan;WANG Hongjuan;CHEN Wei;ZHU Xiujuan;FENG Liang(Department of Anesthesiology,Nantong Municipal Second People's Hospital,Nantong,Jiangsu Province 226600,China)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第2期153-157,共5页
Journal of Interventional Radiology
关键词
超声引导
剖宫产
疼痛
腰方肌筋膜平面阻滞
腹横肌筋膜平面阻滞
ultrasound guidance
cesarean section
pain
quadratus lumborum fascial plane block
transverse abdominis fascial plane block
