【罂粟摘要】腹横肌平面阻滞和腰方肌阻滞对剖宫产术后急性疼痛的影响：一项随机单盲对照试验
腹横肌平面阻滞和腰方肌阻滞对剖宫产术后急性疼痛的影响：一项随机单盲对照试验
贵州医科大学 高鸿教授课题组
翻译：胡廷菊 编辑：佟睿 审校：曹莹
与剖宫产相关的急性疼痛较常见，却往往易被忽视。这可能影响产妇的生活质量和孩子的发育。研究证明腹横肌平面阻滞（TAPB）和腰方肌阻滞（QLB）等区域阻滞技术对治疗剖宫产术后疼痛有效。尽管几项随机对照试验和一项meta分析已经证明TAPB和QLB对剖宫产术后急、慢性疼痛的有效性，但仅有一项研究直接比较了这两种类型的区域阻滞，并揭示QLB优于TAPB。我们的研究旨在再次评估TAPB和QLB在控制剖宫产术后急性疼痛中的作用。我们招募了197位在腰麻下行剖宫产的单胎妊娠孕妇，腰麻后随机分为TAPB组和QLB组。用视觉模拟评分法（VAS）来评估产妇术后2,4,8,12,24小时的急性疼痛。两组间的急性术后疼痛差异无统计学意义。接受TAPB的产妇对补救吗啡注射的需求更高。在我们研究得出，这两种阻滞技术在术后急性疼痛的管理方面没有哪一种区域阻滞比另一种体更具优势。
关键词
疼痛；剖宫产；镇痛；腰方肌阻滞；腹横肌平面阻滞
Michał Borys, Beata Potr ˛e´c-Studzi ´nska , Paweł Kutnik, et al.The Effectiveness of Transversus Abdominis Plane and Quadratus Lumborum Blocks in Acute Postoperative Pain Following Cesarean Section—A Randomized, Single-Blind, Controlled Trial[J]Int. J. Environ. Res. Public Health 2021, 18, 7034. https://doi.org/10.3390/ijerph18137034.
The Effectiveness of Transversus Abdominis Plane and Quadratus Lumborum Blocks in Acute Postoperative Pain Following Cesarean Section—A Randomized, Single-Blind, Controlled Trial
Abstract
Acute pain intensity related to cesarean section (CS) may be extensive and is often underestimated. This may influence mothers’ quality of life and their children’s development. Regional analgesia techniques that include transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) have proven their effificacy in the postoperative period after CS. Although several randomized controlled studies and one meta-analysis have investigated the utility of TAPB and QLB in the reduction of acute and chronic pain after CS, only one study directly compared both types of regional blocks and revealed superiority of QLB over TAPB. Our study aimed to reevaluate the effectiveness of transversus TAPB and QLB in controlling acute postoperative pain after CS. We recruited 197 women with singleton pregnancies undergoing CS under spinal anesthesia. The patients were randomized to receive either TAPB or QLB after CS. The acute postoperative pain was evaluated using the visual analog scale (VAS) at 2, 4, 8, 12 and 24 h after the operation. No significant difference in acute postoperative pain intensity between the groups was found. The patients who received TAPB had a higher demand for supplemental morphine injections (p < 0.039). In our study, none of the evaluated regional blocks demonstrated an advantage over the other regarding acute postoperative pain management.
Keywords
pain; cesarean section; analgesia; quadratus abdominis block; transverse abdominis plane block