CAJ | 학술논문

【目的】研究比较不同浓度的罗哌卡因腹横肌平面阻滞在剖宫产术后镇痛的临床效果。【方法】选取长沙市妇幼保健院腰部麻醉下行剖宫产的足月孕产妇共300例，由计算机随机排序分为A、B、C三组，每组患者100例，A、B、C组孕产妇术后分别按1．5 mg／kg的规格给予注射0．15％、0．20％和0．25％的罗哌卡因，所有患者均使用镇痛泵辅助镇痛。详细观察并记录三组患者术后不同时间节点的视觉模拟评分（VAS ）评分、患者镇痛泵按压次数以及产妇对镇痛效果的满意程度及腹横肌平面阻滞并发症情况。【结果】A组产妇的VAS评分高于B组和C组，且两者相比差异均具有显著性（ P＜0．05）；24 h后B组产妇的VAS评分与C组相比差异具有统计学意义（ P ＜0．05）；三组产妇镇痛满意度分别为71．0％、91．0％和95．0％，A组与B组，C组相比差异具有统计学意义（ P ＜0．05）；A组产妇术后按压镇痛泵次数明显高于B组和C组，且两者相比差异均具有统计学意义（ P ＜0．05）。三组产妇均无并发症发生。【结论】0．20％及0．25％的罗哌卡因腹横肌平面阻滞用于剖宫产产妇术后的镇痛效果显著而且具有较高的安全性，值得临床推广应用。
【목적】연구비교불동농도적라고잡인복횡기평면조체재부궁산술후진통적림상효과。【방법】선취장사시부유보건원요부마취하행부궁산적족월잉산부공300례，유계산궤수궤배서분위A、B、C삼조，매조환자100례，A、B、C조잉산부술후분별안1．5 mg／kg적규격급여주사0．15％、0．20％화0．25％적라고잡인，소유환자균사용진통빙보조진통。상세관찰병기록삼조환자술후불동시간절점적시각모의평분（VAS ）평분、환자진통빙안압차수이급산부대진통효과적만의정도급복횡기평면조체병발증정황。【결과】A조산부적VAS평분고우B조화C조，차량자상비차이균구유현저성（ P＜0．05）；24 h후B조산부적VAS평분여C조상비차이구유통계학의의（ P ＜0．05）；삼조산부진통만의도분별위71．0％、91．0％화95．0％，A조여B조，C조상비차이구유통계학의의（ P ＜0．05）；A조산부술후안압진통빙차수명현고우B조화C조，차량자상비차이균구유통계학의의（ P ＜0．05）。삼조산부균무병발증발생。【결론】0．20％급0．25％적라고잡인복횡기평면조체용우부궁산산부술후적진통효과현저이차구유교고적안전성，치득림상추엄응용。
[Objective] To explore the clinical efficacies of different doses of ropivacaine for post‐cesarean delivery analgesia controlled by transversus abdominis plane blockage .[Methods]A total of 300 cases of lying‐in women ,receiving morphine under spinal anesthesia for caesarean delivery ,were divided randomly into A ,B and C groups ( n =100 each) .They received an injection of 0 .15% ,0 .20% and 0 .25% 1 .5 mg/kg ropiva‐caine respectively .Patient‐controlled analgesia (PCA) was applied for pain alleviation .Visual analogue scale (VAS) scores ,frequency of PCA demand ,patient satisfaction on PCA and complications of transversus abdo‐minis plane blockage were observed and recorded at various timepoints .[Results] The VAS scores of group A were higher than those of group B or group C .And the differences were significantly different ( P<0 .05);at 24h ,the VAS scores were significantly different between groups B and C ( P <0 .05);the PAC satisfaction levels of groups A ,B and C were 71 .0% 、91 .0% and 95 .0% respectively .As compared with group B or group C ,group A had statistic differences ( P <0 .05);the frequency of PAC demand was greatly higher for group A than those for groups B and C .And the differences were statistically significant ( P<0 .05) .For all three groups ,there was no onset of complications .[Conclusion] The uses of 0 .20% and 0 .25% ropivacaine for post‐cesarean delivery analgesia controlled by transversus abdominis plane blockage have remarkable pro‐files of efficacy and safety .And it is worthy of wider popularization .