髂腹股沟和髂腹下神经阻滞对剖宫产术后急性和慢性疼痛的缓解:一项随机对照试验

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髂腹股沟和髂腹下神经阻滞对剖宫产术后急性和慢性疼痛的缓

解:一项随机对照试验

贵州医科大学    麻醉与心脏电生理课题组

翻译：安丽  编辑：潘志军  审校：曹莹

背景：在埃及，剖宫产率呈上升趋势。医务人员尝试使用多种方法来治疗剖宫产（CS）术后疼痛。

目的：本研究旨在评估超声引导下双侧髂腹股沟和髂腹下神经阻滞对CS术后镇痛的疗效观察。

方法：本课题选择期需行剖宫产术的产妇64例纳入研究对象，随机分为两组。C组：对照组与B组：阻滞组。C组：不实施神经阻滞；B组：实施神经阻滞。比较两组患者术后疼痛、吗啡用量、止痛时间和并发症的情况。

结果：两组患者的一般情况和手术时间无显著差异。B组在休息和运动时的疼痛评分明显低于对照组，尤其是在术后12小时内。B组的吗啡消耗量显著低于C组，分别为（4.53±1.456mg）与（8.87±2.013mg），P<0.001。B组的首次补救镇痛时间明显长于C组，分别为（12.25 h与3.81 h）。C组的瘙痒和恶心发生率明显高于B组。B组术后慢性疼痛的发生率显著降低。

结论：髂腹股沟和髂腹下神经阻滞是治疗CS术后疼痛的有效和安全的方法，可显著改善CS后急性和慢性疼痛。

原始文献来源：Laila Elahwal, Shimaa Elrahwan and Amr Arafa Elbadry. Ilioinguinal and Iliohypogastric Nerve Block for Acute and Chronic Pain Relief After Caesarean Section: A Randomized Controlled Trial.Anesth Pain Med. 2022 April; 12(2):e121837. Doi: 10.5812/aapm.121837

英文原文    

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

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.

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