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| Postoperative analgesic effect comparison of ultrasound-guided ropivacaine quadratus lumborum block or transversus abdominis plane block during cesarean section of puerperae |
| Xichang People's Hospital, Xichang, Sichuan Province, 615000 |
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Abstract To explore the postoperative analgesic effect comparison of ultrasound-guided ropivacaine quadratus lumborum block (QLB) or transversus abdominis plane block (TAPB) during cesarean section of puerperae. Methods: 142 puerperae who wanted cesarean section were selected and were divided into two groups (71 cases in each group) according to the different anesthesia methods from January 2023 to July 2023. The puerperae in the two groups were all given spinalepidural anesthesia during cesarean section. The puerperae in group A were injected with ropivacaine into quadratus lumborum and the puerperae in group B were injected with ropivacaine between obliquus internus abdominis and transversus abdominis. The analgesic effect evaluated by VAS score, the comfort evaluated by comfort score, the clinical activities situation at different time points (at postoperative 4, 8, 12, 24 and 48 h), the consumption of sedatives in 2d after surgery and the incidence rates of postoperative adverse reaction of the puerperae were compared between the two groups. Results: There was no significant difference in the scores of VAS and comfort of the puerperae at postoperative 4h and 8h between the two groups (P>0.05). The VAS scores of the puerperae in group A at postoperative 12h, 24h and 48h (2.25±0.33 points, 2.05±0.52 points and 1.82±0.34 points) were significantly lower than those (2.42±0.40 points, 2.23±0.43 points and 1.93±0.30 points) of the puerperae in group B. The comfort scores of the puerperae in group A at postoperative 12h, 24h and 48h (2.29±0.23 points, 2.52±0.22 points and 2.76±0.32 points) were significantly higher than those (2.16±0.30 points, 2.30±0.29 points and 2.51±0.30 points) of the puerperae in group B (all P<0.05). There was no significant difference in the first sitting time and eating time of the puerperae between the two groups (P>0.05). The first standing time (5.34±1.26h) and the walking time (7.42±1.71h) of the puerperae in group A were significantly shorter than those (6.25±1.35h and 9.06±2.30h) of the puerperae in group B. The consumption of sedatives (38.50±5.63μg) of the puerperae in group A was significantly less than that (77.23±7.85μg) of the puerperae in group B, and the incidence of adverse reactions (11.3%) of the puerperae in group A was significantly lower than that (25.4%) of the puerperae in group B (all P<0.05). Conclusion: Both ropivacaine QLB and ropivacaine TAPB during cesarean section of the puerperae can provide their effective postoperative analgesia. The ropivacaine QLB has more obvious advantages in the analgesia time and effect, and the reduction of adverse reactions of the puerperae.
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