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《不同剂量罗哌卡因腹横肌平面阻滞在剖宫产术后镇痛中的疗效比较》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、·1788·2013年12月第25卷第12期MedJWestChina,December2013,Vo1.25,No.12不同剂量罗哌卡因腹横肌平面阻滞在剖宫产术后镇痛中的疗效比较*郑珈琳,罗世忠,钟庆,郭昌立,张玲(1.安岳县人民医院麻醉科,重症医学科,INN安岳642350;2.简阳市人民医院麻醉科,四川简阳641400)【摘要】目的比较剖宫产术后不同剂量罗哌卡因在超声引导下行腹横肌平面阻滞(transversusabdomina1Dlane,TAP)镇痛中的疗效。方法实施单次腰麻下剖宫产单胎足月孕初产妇6O
2、例,计算机排序随机分为A组(0.5罗哌卡因3mg/kg)、B组(O.5罗哌卡因1.5mg/kg)和C组(对照组)各20倒。在手术结束后实施超声引导下TAP。观察48小时内各随访时点的疼痛评分(numerica1ratingscale,NRS)和产妇满意度评分。48小时内辅助镇痛药使用频率。结果产妇在术后6及12小时时点NRS运动时评分,A组明显低于B组和C组(P0.05);NRS静息时评分各时点组间比较皆无差异(P>0.05)。各组产妇满意度评分无差异(P>0.05)。72
3、小时内辅助镇痛药使用率各组间无差异(P>O.05)。结论超声引导下单次0.5%罗哌卡因3mg/kg剂量腹横肌平面阻滞可以产生良好的12小时左右的产科术后镇痛,但更长时间的持续镇痛需要改进操作方法。【关键词】罗哌卡因;超声;腹横肌平面阻滞;剖宫产;术后镇痛【中图分类号】R719;R614.24;【文献标志码】Adoi:10.3969/j.issn.1672—3511.2013.12.010Comparisonoftwodosesofropivacaineinpostoperativepaincontrolbyult
4、rasound—guidedtransversusabdominisplaneblocksforpost—cesareandeliveryanalgesiaZHENJia-lin,LUOShi—zong,ZhongQing,etal(DepartmentofAe5hP{0Z0gandIntensiveCareUnit,AnyuePeople'sHospital,Anyue642350,Sichuan,China)[Abstract]ObjectiveTocomparedtheanalgesicefficacyof
5、twodosesoflocalanestheticropivacaineforTAP(transversusabdominalplane)blocksaftercesareandelivery(CD).MethodsEachofthe20casesofsixtywomenhay—ingCDunderspinalanesthesiawererandomizedtoreceiveultrasound—guidedTAPblocksusing0.53mg/kgdoseropi—vacaine(Agroup),1.5mg
6、/kgropivacaine(Bgroup)orplacebo(Cgroup).AfterCDprocedure,thethreegroupsofpa—tientsreceivedTAP.QualityofthepatientfpainwasevaluatedbyNRS(numericalratingscale)atrestandmovement,andmaternalsatisfactionscore,stillusingtheNRS.Thedemographicdataandandincidenceofusi
7、ngmedicationsafterCDin72hwererecordedinal1groups.ResultsPostoperative6hand14htimepointsinAgroup,NRSmovementscoresweresignificantlylowerthantheBandCgroup(P0.05).A1ltheNRSscoresatrestweresimilarbetw
8、eengroups(P>0.05).Thematernalsatisfactionandmedicationsusedin72hafterCSinthreegroupshadnodifference(P>O.05).Conclusion0.53mg/kgdoseropiva—caineTAPblocksmayimprovepainscoresupto12hafterces
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