Efficacy of ultrasound-guided iliohypogastric∕ilioinguinal nerve block and transversus abdominis plane block for analgesia after cesarean section
10.3760∕cma.j.issn.0254-1416.2016.09.015
- VernacularTitle:超声引导髂腹下∕髂腹股沟神经阻滞和腹横肌平面阻滞用于剖宫产术后镇痛的效果
- Author:
Nan LIU
;
Xizhe ZHANG
;
Yi FENG
- Keywords:
Ilium;
Abdominal muscles;
Nerve block;
Ultrasonography;
Analgesia,obstet-rical
- From:
Chinese Journal of Anesthesiology
2016;36(9):1098-1101
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of ultrasound?guided iliohypogastric∕ilioinguinal nerve block and transversus abdominis plane block for analgesia after cesarean section. Methods Ninety parturients, aged 20-40 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective cesarean section, were divided into 3 groups ( n=30 each) using a random number table:con?trol group (group C), ultrasound?guided iliohypogastric∕ilioinguinal nerve block group (group IH∕II) and ultrasound?guided transversus abdominis plane block group (group TAP). In IH∕II and TAP groups, bilat?eral ultrasound?guided iliohypogastric∕ilioinguinal nerve block and transversus abdominis plane block were performed after surgery, respectively, with 0.5% ropivacaine 1.5 mg∕kg ( the maximal dose 100 mg) plus dexamethasone 5 mg for each side. All the patients received patient?controlled intravenous analgesia with morphine after surgery, and numeric rating scales scores at rest and during movement were maintained<4 within the 48 h after surgery. The cumulative consumption of morphine was recorded at 6, 12, 24, 36 and 48 h after surgery. The occurrence of adverse reactions such as nausea, vomiting, pruritus, over?sedation and respiratory depression was observed and recorded in the analgesic period. Results Compared with group C, the cumulative consumption of morphine was significantly decreased at each time point in IH∕II and TAP groups ( P<0.01) . Compared with group IH∕II, no significant change was found in the cumulative consumption of morphine at 6 and 12 h after surgery, and the cumulative consumption of morphine was sig?nificantly increased at 24, 36 and 48 h after surgery in group TAP ( P<0.05) . No nausea, vomiting, pru?
ritus, over?sedation and respiratory depression was found in IH∕II and TAP groups. Conclusion For par?turients, ultrasound?guided iliohypogastric∕ilioinguinal nerve block and transversus abdominis plane block both can provide analgesic efficacy after cesarean section, and the efficacy of the former one is better.
