Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Ave. 1095#, 430030 Wuhan, China.
Anesth Analg. 2011 Jul;113(1):134-7. doi: 10.1213/ANE.0b013e31821891e2. Epub 2011 Apr 5.
The ultrasound-guided transversus abdominis plane block and ilioinguinal-iliohypogastric nerve block have been shown to provide pain relief after abdominal surgery. A combination of the 2 blocks may provide acceptable surgical anesthesia for cesarean delivery. We describe 4 women who had contraindications to neuraxial anesthesia, who underwent cesarean delivery with ultrasound-guided bilateral transversus abdominis plane block combined with ilioinguinal-iliohypogastric nerve block using 40 mL 0.5% ropivacaine. Breakthrough pain during the delivery of the fetus was treated with small doses of IV ketamine and propofol. We suggest that this technique may be an alternative to local anesthesia for cesarean delivery in clinical practice.
超声引导下腹横肌平面阻滞和髂腹股沟-髂腹下神经阻滞已被证明可在腹部手术后缓解疼痛。这两种阻滞方法的联合应用可能为剖宫产提供可接受的手术麻醉。我们描述了 4 名存在椎管内麻醉禁忌证的妇女，她们接受了超声引导下双侧腹横肌平面阻滞联合髂腹股沟-髂腹下神经阻滞，使用 40mL0.5%罗哌卡因进行剖宫产。胎儿娩出过程中出现爆发性疼痛时，给予小剂量 IV 氯胺酮和异丙酚治疗。我们建议，在临床实践中，这种技术可能是剖宫产局部麻醉的替代方法。
