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| Effects of ultrasound-guided quadratus lumbosum block or transversus abdominis plane block under multimodal analgesia regimen during cesarean section on blood pressure and fetal internal environment |
| Fushun County People's Hospital, Zigong, Sichuan Province, 643200 |
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Abstract To analyze the effects of ultrasound-guided quadratus lumborum block or transverse abdominis plane block under the guidance of multimodal analgesia regimen during cesarean section of pregnant women on their blood pressure and fetal internal environment of undergoing. Methods: 106 pregnant women who wanted cesarean section were selected and were divided into control group(n=52)and observation group(n=54)according to the random number table method between June 2019 and June 2021. The women in the control group were treated with ultrasound-guided transversus abdominis plane block under multimodal analgesia regimen, and the women in the observation group were given ultrasound-guided quadratus lumbosum block under multimodal analgesia regimen. The analgesic effect evaluated by Visual Analogue Scale(VAS)or the sedation degree evaluated by Ramsay sedation scoring method of the women before anesthesia(T1), after 10 min of anesthesia and block(T2), immediately after surgery(T3), and at 4 h after surgery(T4)and at 12 h after surgery(T5)was conducted. The blood pressure changes of the women at T1, T2, T3, T4, and T5 were compared between the two groups. The changes of fetal internal environment evaluated by blood gas analysis and Apgar score of the newborns were compared between the two groups. Results: The VAS score of the women in the observation group after anesthesia and block, at T3, T4, and T5 was significantly lower than that of the women in the control group, which had interaction effects between time and grouping. The VAS score of the women in the observation group at T2-T4 was significantly lower than that of the women in the control group(all P＜0.05). There were significant differences in Ramsay sedation scores of the women in the two groups among different time points(P＜0.05), but there were no significant differences in Ramsay sedation scores of the women at different time points between the two groups(P＞0.05). There was significant difference in the mean blood pressure value of the women at different time points between the two groups(P＜0.05), but there was no significant difference in the mean blood pressure value of the women in the two groups among different time points. There were no significant differences in the values of blood gas oxygen partial pressure, carbon dioxide partial pressure, and lactate value in fetal umbilical artery blood, and the Agar scores of the newborns between the two groups(P＞0.05). Conclusion: The analgesic and sedative effects of the pregnant women of ultrasound-guided quadratus lumborum block under the guidance of multimodal analgesia regimen during cesarean section are better than those of ultrasound-guided transverse abdominis plane block, and both of which have no significantly effect on the maternal vital signs and the stability of fetal internal environment.
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