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髂腹股沟神经和髂腹下神经阻滞对剖宫产术后疼痛的疗效。

The efficacy of ilioinguinal and iliohypogastric nerve block for postoperative pain after caesarean section.

作者信息

Sakalli Melike, Ceyhan Ayşegül, Uysal Hale Yarkan, Yazici Işin, Başar Hülya

机构信息

Anaesthesiologist, Ankara Training and Research Hospital, Anaesthesiology and Reanimation Clinic, Ankara, Turkey.

出版信息

J Res Med Sci. 2010 Jan;15(1):6-13.

Abstract

BACKGROUND

The effect of ilioinguinal and iliohypogastric (II-IH) nerve block on postoperative pain is well documented when performed before Caesarean section (CS) but the efficacy remains unclear when performed after the surgical procedure. The aim of this study is to investigate the effect of II-IH nerve block on postoperative pain and analgesic consumption in patients when performed after CS.

METHODS

Sixty ASA I- II patients, scheduled for elective CS were included in the study. After general anaesthesia, patients were allocated into 2 groups randomly. In group I bilateral II-IH block has been performed after the skin closure, with 10 ml of 0.5% ropivacaine on each side. In group II sham block had been performed. For postoperative analgesia all patients received tramadol via i.v patient controlled analgesia. Visual analogue scale (VAS) scored tramadol consumption and side effects.

RESULTS

The mean VAS scores in II-IH block group were significantly lower than in sham block group at 6(th), 8(th), 12(th), 24(th) hours at rest (p < 0.05) and at 6(th), 8(th) hours with movement (p < 0.05). Tramadol usage in II-IH block group was significantly less than in sham block group at all estimated time intervals (p < 0.05). Total tramadol consumption was 331 ± 82 mg in II-IH block group and 622 ± 107 mg in sham block group (p < 0.05).

CONCLUSIONS

It was observed that II-IH nerve block when performed after the surgery may reduce analgesic consumption after CS.

摘要

背景

腹股沟髂腹下神经(II-IH)阻滞在剖宫产术(CS)前进行时对术后疼痛的影响已有充分记录,但在手术操作后进行时其疗效仍不明确。本研究的目的是调查CS术后进行II-IH神经阻滞对患者术后疼痛和镇痛药物消耗量的影响。

方法

本研究纳入了60例计划行择期CS的ASA I-II级患者。全身麻醉后,患者被随机分为两组。在I组中,皮肤缝合后进行双侧II-IH阻滞,每侧注射10 ml 0.5%罗哌卡因。在II组中,进行假阻滞。所有患者术后均通过静脉自控镇痛接受曲马多治疗。采用视觉模拟评分法(VAS)对曲马多消耗量和副作用进行评分。

结果

II-IH阻滞组在静息状态下第6、8、12、24小时的平均VAS评分显著低于假阻滞组(p<0.05),在活动时第6、8小时也显著低于假阻滞组(p<0.05)。在所有估计时间间隔内,II-IH阻滞组的曲马多用量均显著少于假阻滞组(p<0.05)。II-IH阻滞组曲马多总消耗量为331±82 mg,假阻滞组为622±107 mg(p<0.05)。

结论

观察到术后进行II-IH神经阻滞可能会减少CS术后的镇痛药物消耗量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8f6/3082784/5a2039abe020/JRMS-15-6-g001.jpg

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