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

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1、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。方法此次研宄的对象是选择ASAI〜II级，择期在腰硬联合麻醉下行剖宫产手术产妇100例，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20ml,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4h、8h、12h、24h的VAS评分及镇痛效果、镇痛泵按压次数。结果A组术后4h、

2、8h、12h,24h的VAS评分显著低于B组(P<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(P<001)。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&plUSmn;7.8)次，A组术后镇痛泵按压次数显著少于B组(P<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

3、横肌平面阻滞；剖宫产术后镇痛[Abstract]ObjectiveToinvestigateandanalyzetheapplicationeffectoflevobupivacainetransversusabdominisplaneblockanalgesiaaftercesareansection.MethodsthestudysubjectswereselectedASAI〜II，electiveinthecombinedspinalepiduralanesthesiacesareansectionmaternal100caseswererandomlydivide

4、dintoAgroupandBgroup，eachof50cases.Afteroperationintwogroupswereunderultrasoundguidanceunderwentbilateraltransversusabdominisplaneblock(TAP)，agroupofinjectionof0.25%levobupivacaine20ml,groupBinjectedwithagroupofequalamountsofsaline.Allwomenafterusingpatient-controlledintravenousanalgesia(P

5、CIA)forpostoperativeanalgesia,usingavisualanaloguescale(VAS)evaluation,werecomparedbetweenthetwogroupsafter4h,8h,12h，24hvasandanalgesiceffect，analgesiapumppressingtimes.ResultsingroupAafter4h,8h，12h，24hVASscorewassignificantlylowerthanthatofgroupB(P<0.01).Afteroperationingroupapatientsa

6、tisfactionwas84.0%(42/50),afteroperationingroupBanalgesicsatisfactionfor58.0%(29/50).AfteroperationingroupaanalgesicsatisfactionsignificantlyhigherthaningroupB(P<001).Afteroperation，thenumberofpressingtimesoftheAgroupwas(12.3+3.6)times,thenumberoftimesoftheBgroupwas(35.4+7.8),thenumbero

7、fpostoperativeanalgesiapumpwassignificantlylessthanBgroup(P<0.01).Noadversereactionsrelatedtopostoperativeanalgesiawerefoundinthetwogroups.Conclusionultrasoundguidedunderlevobupivacainetransversusabdominisplaneblockcesareansectionforpostoperativeanalgesiais