超声引导髂腹下/髂腹股沟神经阻滞对剖宫产术后镇痛效果的影响

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摘要目的研究超声引导髂腹下/髂腹股沟神经阻滞对剖宫产术后镇痛效果的影响。方法选择2019年4月—2020年3月于安徽省黄山首康医院行剖宫产分娩的80例产妇进行研究。按照随机数字表法分为对照组和试验组，各40例。对照组术后给予静脉自控镇痛，试验组在对照组基础上联合超声引导髂腹下/髂腹股沟神经阻滞镇痛。分析两组术前6 h及术后12 h视觉模拟评分（VAS），术后24 h内镇痛泵按压次数，首次排气时间，镇痛补救率，不同时间点血清泌乳素水平和初乳时间，并比较两组术后不良反应发生率。结果术后12 h，两组VAS均较术前6 h降低，且试验组VAS低于对照组，差异有统计学意义（P < 0.05）。试验组术后24 h内镇痛泵按压次数少于对照组，首次排气时间短于对照组，镇痛补救率低于对照组，差异有统计学意义（P < 0.05）。术后24 h，两组血清泌乳素水平均较术前1 d升高，且试验组血清泌乳素水平高于对照组，差异有统计学意义（P < 0.05）；试验组初乳时间短于对照组，差异有统计学意义（P < 0.05）。两组术后24 h内不良反应总发生率比较，差异无统计学意义（P > 0.05）。结论超声引导髂腹下/髂腹股沟神经阻滞能够有效减轻产妇术后疼痛，并可促进胃肠功能恢复和早泌乳，值得推广应用。

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	王伟明

关键词 ：剖宫产, 术后镇痛, 超声引导, 髂腹下/髂腹股沟神经阻滞

Abstract：Objective To study the effect of ultrasound-guided iliohypogastric/ilioinguinal nerve block on postoperative analgesia after cesarean section. Methods From April 2019 to March 2020, 80 pregnant women who had cesarean section in Huangshan Shoukang Hospital of Anhui Province were selected for the study. They were divided into control group and experimental group according to random number table, 40 cases in each group. Control group was given patient-controlled intravenous analgesia, and experimental group was given ultrasound-guided iliohypogastric/ilioinguinal nerve block analgesia on the basis of control group. Visual analogue scale (VAS) six hours before operation and 12 hours after operation, times of pressing analgesia pump, time of first exhaust and recovery rate of analgesia, serum prolactin level at different time points and colostrum time in two groups were analyzed. The incidence of adverse reactions was compared between two groups. Results At 12 hours after operation, VAS of two groups was lower than that of six hours before operation, and VAS of experimental group was lower than that of control group, the difference was statistically significant (P < 0.05). The times of pressing analgesia pump in experimental group were less than those in control group within 24 hours after operation, the first exhaust time of experimental group was shorter than that of control group, and the analgesic recovery rate of experimental group was lower than that of control group, the difference was statistically significant (P < 0.05). Twenty four hours after operation, the serum prolactin levels of two groups were higher than that of one day before operation, and the serum prolactin level of experimental group was higher than that of control group, the difference was statistically significant (P < 0.05). The colostrum time of experimental group was shorter than that of control group (P < 0.05). There was no significant difference in the total incidence of adverse reactions between two groups within 24 hours (P > 0.05). Conclusion Ultrasound-guided iliohypogastric/ilioinguinal nerve block can effectively relieve postoperative pain and promote gastrointestinal function recovery and early lactation, it is worth popularizing and applying.

Key words： Cesarean section Postoperative analgesia Ultrasonic guidance Iliohypogastric/ilioinguinal nerve block

引用本文:

王伟明. 超声引导髂腹下/髂腹股沟神经阻滞对剖宫产术后镇痛效果的影响[J]. 中国医药导报, 2021, 18(1): 119-122.
WANG Weiming. Effect of ultrasound-guided iliohypogastric / ilioinguinal nerve block on postoperative analgesia after cesarean section. 中国医药导报, 2021, 18(1): 119-122.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2021/V18/I1/119

[1] 应泽华，孙德友，徐鹏，等.不同术后镇痛方式对剖宫产产妇产后微循环与疼痛指标的影响比较[J].四川医学，2017，38（5）：554-556.
[2] Fay EE，Hitti JE，Delgado CM，et al. An enhanced recovery after surgery pathway for cesarean delivery decreases hospital stay and cost [J]. Am J Obstet Gynecol，2019，221（4）：349.e1.
[3] M?覿kel?覿 K，Palom?覿ki O，Pokkinen S，et al. Oral versus patient-controlled intravenous administration of oxycodone for pain relief after cesarean section [J]. Arch Gynecol Obstet，2019，300（4）：903-909.
[4] Habibi A，Alipour A，Baradari AG，et al. The effect of adding lidocaine to patient controlled analgesia with morphine on pain intensity after caesarean section with spinal anesthesia：a double-blind，randomized，clinical trial [J]. Open Access Maced J Med Sci，2019，7（12）：1946-1950.
[5] Sujatha C，Zachariah M，Ranjan RV，et al. Transversus abdominis plane block versus ilioinguinal/iliohypogastric nerveblock with wound infiltration for postoperative analgesia in inguinal hernia surgery：a randomized clinical trial [J]. Anesth Essays Res，2017，11（4）：976-980.
[6] 廖光东，罗东，姚强.美国妇产科医师学会“2017产科镇痛和麻醉实践指南”解读[J].实用妇产科杂志，2017，33（8）：31-34.
[7] 严广斌.视觉模拟评分法[J].中华关节外科杂志：电子版，2014，8（2）：273.
[8] Jafarzadeh A，Hadavi M，Hasanshahi G，et al. Cesarean or cesarean epidemic [J]. Arch Iran Med，2019，22（11）：663-670.
[9] Lavand'homme P. Postoperative cesarean pain：real but is it preventable [J]. Curr Opin Anaesthesiol， 2018，31（3）：262-267.
[10] Sutton CD，Carvalho B. Optimal pain management after cesarean delivery [J]. Anesthesiol Clin，2017，35（1）：107-124.
[11] 高申山.剖宫产术后镇痛的研究进展[J].广东医学，2017， 38（z1）：341-342.
[12] 梅天姿，韩宝庆，戚思华.剖宫产术后镇痛策略的研究进展[J].现代生物医学进展，2019，19（10）：1997-2000.
[13] Kintu A，Abdulla S，Lubikire A，et al. Postoperative pain after cesarean section：assessment and management in a tertiary hospital in a low-income country [J]. BMC Health Serv Res，2019，19（1）：68.
[14] 张国梁，任燕，孟明华，等.超声引导下连续腹横肌平面阻滞对剖宫产产妇术后镇痛的效果[J].山东医药，2017， 57（37）：84-86.
[15] Yamak Altinpulluk E，García Simón D，Fajardo-Pérez M. Erector spinae plane block for analgesia after lower segment caesareansection：case report [J]. Rev Esp Anestesiol Reanim，2018，65（5）：284-286.
[16] Kiran LV，Sivashanmugam T，Kumar VRH，et al. Relative efficacy of ultrasound-guided ilioinguinal-iliohypogastric nerve block versus transverse abdominis plane block for postoperative analgesia following lower segment cesarean section：a prospective，randomized observer-blinded trial [J]. Anesth Essays Res，2017，11（3）：713-717.
[17] 李歆跃，薛照静，薛富善，等.超声引导下腰方肌后阻滞和连续硬膜外镇痛对剖宫产术后镇痛效果的比较[J].临床和实验医学杂志，2020，19（8）：891-895.
[18] Mieszkowski MM，Mayzner-Zawadzka E，Tuyakov B，et al. Valuation of the effectiveness of the quadratus lumborum block type Ⅰ using ropivacaine in postoperative analgesia after a cesarean section—a controlled clinical study [J]. Ginekol Pol，2018，89（2）：89-96.
[19] 李林佶，李顺洪，袁卫国，等.右美托咪定复合罗哌卡因腹横平面阻滞用于剖宫产术后镇痛的效果[J].西部医学，2018，30（5）：707-710.
[20] 赵婷，周红娟，吴家伟.罗哌卡因复合芬太尼腹横肌平面阻滞对剖宫产产妇术后疼痛、血流动力学及泌乳功能的影响[J].实用临床医药杂志，2019，23（1）：87-90.
[21] Yazici Yilmaz F，Aydogan Mathyk B，Yildiz S，et al. Postoperative pain and neuropathy after caesarean operation featuring blunt or sharp opening of the fascia：a randomised，parallel group，double-blind study [J]. J Obstet Gynaecol，2018，38（7）：933-939.
[22] 全耀晨，吴超，刘路，等.超声引导下行双侧腹横肌平面阻滞对产妇术后镇痛和舒芬太尼用量及血清催乳素水平的影响[J].解放军医药杂志，2018，30（11）：94-97.
[23] 李建春.腰硬麻醉联合地佐辛静脉自控镇痛对剖宫产术后镇痛及泌乳素的影响[J].中国妇幼保健，2017，32（22）：5753-5756.
[24] 徐红.剖宫产术后两种镇痛方法对血清泌乳素的影响[J].武警医学，2017，28（7）：698-700，703.
[25] Gamez BH，Habib AS. Predicting severity of acute pain after cesarean delivery：a narrative review [J]. Anesth Analg，2018，126（5）：1606-1614.