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| Effect of ultrasound-guided iliohypogastric / ilioinguinal nerve block on postoperative analgesia after cesarean section |
| WANG Weiming |
| Department of Anesthesiology, Huangshan Shoukang Hospital of Anhui Province, Anhui Province, Huangshan 245000, China |
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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.
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[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. |
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