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髂腹股沟神经和髂腹下神经阻滞用于剖宫产术后急慢性疼痛缓解:一项随机对照试验

Ilioinguinal and Iliohypogastric Nerve Block for Acute and Chronic Pain Relief After Caesarean Section: A Randomized Controlled Trial.

作者信息

Elahwal Laila, Elrahwan Shimaa, Elbadry Amr Arafa

机构信息

Faculty of Medicine, Tanta University, Tanta, Egypt.

出版信息

Anesth Pain Med. 2022 Mar 27;12(2):e121837. doi: 10.5812/aapm.121837. eCollection 2022 Apr.

Abstract

BACKGROUND

There is an increasing cesarean section (CS) rate in Egypt. Multiple methods are used to manage pain after CS.

OBJECTIVES

This study aimed to assess the effect of ultrasound-guided bilateral ilioinguinal and iliohypogastric nerve block on pain reduction after CS.

METHODS

We classified 64 cases of elective CS into two equal groups. The block group underwent the nerve block, and the control group did not. Postoperative pain, morphine consumption, time to analgesic request, and complications were compared between the two groups.

RESULTS

No significant difference was detected between the two groups regarding patient characteristics or operation duration. However, pain scores during rest and movement were significantly lower in the block group than in controls, especially within the first 12 hours following the operation. Morphine consumption was significantly lower in the block group (4.53 ± 1.456) in group B vs. (8.87 ± 2.013) in group C with P-value < 0.001. Time to the first rescue analgesia was significantly longer in the intervention group than in the other group (12.25 vs. 3.81 hours). Pruritis and nausea incidence was significantly higher in controls than in the block group. The incidence of chronic postoperative pain was significantly lower in the block group.

CONCLUSIONS

The ilioinguinal and iliohypogastric nerve block is efficient and safe for managing postoperative pain following CS. It is associated with significant improvement of acute and chronic pain after such operations.

摘要

背景

埃及剖宫产率呈上升趋势。剖宫产术后疼痛管理采用多种方法。

目的

本研究旨在评估超声引导下双侧髂腹股沟神经和髂腹下神经阻滞对剖宫产术后疼痛减轻的效果。

方法

我们将64例择期剖宫产病例分为两组,每组人数相等。阻滞组接受神经阻滞,对照组未接受。比较两组的术后疼痛、吗啡用量、首次要求镇痛的时间及并发症。

结果

两组患者在特征或手术时长方面未检测到显著差异。然而,阻滞组休息和活动时的疼痛评分显著低于对照组,尤其是术后12小时内。阻滞组吗啡用量显著低于对照组(B组为4.53±1.456,C组为8.87±2.013,P值<0.001)。干预组首次补救镇痛的时间显著长于另一组(12.25小时对3.81小时)。对照组瘙痒和恶心的发生率显著高于阻滞组。阻滞组慢性术后疼痛的发生率显著更低。

结论

髂腹股沟神经和髂腹下神经阻滞对剖宫产术后疼痛管理有效且安全。它与此类手术后急慢性疼痛的显著改善相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a5e/9375958/7a78322a64e7/aapm-12-2-121837-i001.jpg

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