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河北医学  2019, Vol. 25 Issue (7): 1095-1097    DOI: 10.3969/j.issn.1006-6233.2019.07.010
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超声引导下双侧TAP阻滞联合ⅢH神经阻滞对剖宫产术后切口疼痛的影响
聂彬, 迟晓慧
华中科技大学同济医学院附属同济医院麻醉科, 湖北 武汉 430030
Effect of Ultrasound-guided Bilateral TAP Block Combined with Ⅲ H Nerve Block on Incision Pain after Cesarean Section
NIE Bin, CHI Xiaohui
Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Hubei Wuhan 430030, China
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摘要 目的: 分析探讨超声引导下双侧TAP阻滞联合ⅢH神经阻滞对剖宫产术后切口疼痛的影响。方法: 选取我院于2015年6月至2018年6月期间收治的60例剖宫产手术患者,按照随机数字表法将所有患者简单随机分为对照组和试验组两组,所有患者均采取腰硬联合麻醉,对照组患者在手术结束后均在超声引导下,每侧均给予20mL的0.5%罗哌卡因进行双侧TAP阻滞;而试验组患者则在手术结束后在超声引导下每侧给予20mL的0.5%罗哌卡因进行双侧TAP阻滞联合ⅢH神经阻滞。记录各组患者术后48h内的静息及运动NRS评分,记录两组患者的排气时间和首次下地时间,比较两组患者对术后镇痛方式的满意度以及不良反应发生情况。结果: 两组患者在术后2h的静息及运动NRS评分均为0分,两组患者在其他时间点的静息及运动NRS评分并无明显差异(均P>0.05)。两组患者在治疗后对镇痛的满意度和首次排气时间以及首次下地时间方面并无明显差异(均P>0.05)。治疗后两组患者的镇痛评分和不良反应发生情况均无明显差异(均P>0.05)。结论: 相对于双侧TAP阻滞而言,超声引导下双侧TAP阻滞联合ⅢH神经阻滞并不能有效改善剖宫产患者术后的切口镇痛效果。
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聂彬
迟晓慧
关键词 剖宫产超声检查神经阻滞腹横筋膜平面    
AbstractObjective: To investigate the effect of ultrasound guided bilateral TAP block combined with ⅢH nerve block on incision pain after cesarean section. Methods: 60 cases of cesarean section patients admitted to our hospital from June 2015 to June 2018 were randomly divided into control group and experimental group according to random number table method. All patients were anesthetized with combined spinal-epidural anesthesia. All patients in the control group underwent ultrasound-guided bilateral TAP block with 0.5% ropivacaine of 20mL on each side, while those in the experimental group underwent ultrasound-guided bilateral TAP block with 0.5% ropivacaine of 20 ml on each side. NRS score of rest and exercise in each group within 48 hours after surgery was recorded, exhaust time and first time to the ground of the two groups were recorded, and satisfaction with postoperative analgesia and adverse reactions of the two groups were compared. Results: There was no significant difference in NRS score between the two groups at other time points (all P>0.05). After treatment, there was no significant difference between the two groups in analgesia satisfaction, first exhaust time and first ground floor time (all P>0.05). After treatment, there was no significant difference in sedation score and adverse reactions between the two groups (all P>0.05). Conclusion: Compared with bilateral TAP block, ultrasound-guided bilateral TAP block combined with Ⅲ H block can not effectively improve the analgesic effect of incision after cesarean section.
Key wordsCesarean delivery    Ultrasonic examination    Nerve blocking    Transverse fascia plane
    
基金资助:湖北省自然科学基金项目,(编号:2015CFC045号)
通讯作者: 迟晓慧   
引用本文:   
聂彬, 迟晓慧. 超声引导下双侧TAP阻滞联合ⅢH神经阻滞对剖宫产术后切口疼痛的影响[J]. 河北医学, 2019, 25(7): 1095-1097.
NIE Bin, CHI Xiaohui. Effect of Ultrasound-guided Bilateral TAP Block Combined with Ⅲ H Nerve Block on Incision Pain after Cesarean Section. HeBei Med, 2019, 25(7): 1095-1097.
链接本文:  
http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.07.010     或     http://www.hbyxzzs.cn/CN/Y2019/V25/I7/1095
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