|
|
|
| Effects of Bilateral Quadratus Lumborum Block and Transversus Abdominis Plane Block on Postoperative Analgesia and Serum Inflammatory Factors in Women Undergoing Cesarean Section |
| TANG Hui, LI Bin, HUANG Wei |
| Department of Anesthesiology, Changning District Maternal and Child Health Hospital, Shanghai 200050 |
|
|
|
|
Abstract 【Objective】 To investigate the effects of bilateral quadratus lumborum block (B-QLB) and transversus abdominis plane block (TAPB) on postoperative analgesia and serum levels of monocyte chemoattractant protein-1 (MCP-1), substance P (SP), and 5-hydroxytryptamine (5-HT) in women undergoing cesarean section. 【Methods】 A total of 200 women scheduled for cesarean section were randomly assigned to the control group (n=100, TAPB) and the observation group (n=100, B-QLB). Analgesic efficacy, clinical recovery parameters, resting and movement visual analogue scale (VAS) scores at 4 h, 8 h, 12 h, 24 h, and 48 h postoperatively, serum biomarkers (MCP-1, SP, 5-HT), and adverse events were compared between the two groups. 【Results】 Resting VAS scores showed no significant differences between the two groups (P>0.05). The observation group had lower movement VAS scores at 8 h, 12 h, 24 h, and 48 h (P<0.05). The first pressing time of the analgesia pump in the observation group was longer than that in the control group. The number of effective pressings and the analgesia rescue rate 24 after surgery were lower than those in the control group, and the analgesia satisfaction score was higher than that in the control group (all P<0.05). The observation group also showed shorter times to first standing, first ambulation, and onset of lactation (all P<0.05). Postoperative serum MCP-1, SP, and 5-HT levels in the observation group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions did not differ significantly between groups (P>0.05). 【Conclusion】 Compared with TAPB, B-QLB provides superior postoperative analgesia effect for cesarean section, reduces analgesic consumption, significantly lowers serum MCP-1, SP, and 5-HT levels, and does not increase the risk of adverse events.
|
|
Received: 20 March 2025
|
|
|
|
|
|
[1] 吴瑶瑶,柏效志,谢小娟,等. 右美托咪定对腹横肌平面阻滞疤痕子宫产妇剖宫产术后镇痛及胃肠道功能的影响[J].西部医学,2023,35(9):1385-1389.
[2] 徐学文,李水英,程明静,等. 腹横肌平面阻滞镇痛和腰方肌阻滞镇痛用于HIV感染孕产妇剖宫产术后的镇痛效果及对细胞免疫的影响[J].重庆医科大学学报,2022,47(10):1231-1235.
[3] 吴悦,钱彦,赵康明. 不同入路腰方肌阻滞与腹横肌平面阻滞在剖宫产术后镇痛的效果对比[J].安徽医学,2021,42(9):1022-1025.
[4] 梁晶晶,罗燕,何华英. 后路法和侧路法腹横肌平面阻滞对剖宫产术后镇痛效果的比较[J].四川医学,2019,40(9):943-946.
[5] 李平,李西. 后路腰方肌阻滞复合自控静脉镇痛泵用于剖宫产术后镇痛的效果观察[J].实用医院临床杂志,2021,18(2):118-121.
[6] 单涛,尹骏,孟庆胜,等. 超声引导下腹横筋膜平面阻滞与腹横肌平面阻滞在剖宫产术后镇痛中的效果比较[J].临床麻醉学杂志,2020,36(10):988-991.
[7] 庞西,谭颖,王丽,等. 超声引导下腰方肌阻滞与腹横肌平面阻滞在剖宫产术后镇痛中的比较[J].四川医学,2021,42(7):659-664.
[8] HUSSAIN N, BRULL R, WEAVER T, et al. Postoperative analgesic effectiveness of quadratus lumborum block for cesarean delivery under spinal anesthesia[J].Anesthesiology,2021,134(1):72-87.
[9] KHANNA S, KRISHNA G V, SHARMA V J, et al. Quadratus lumborum block versus transversus abdominis plane block for post Caesarean analgesia:a randomized prospective controlled study[J].Med J Armed Forces India,2022,78(Suppl 1):S82-S88.
[10] 牛富国,李衔强,张彦匣,等. 氢吗啡酮对腰硬联合麻醉剖宫产术后镇痛效果、炎性因子、应激反应和免疫功能的影响[J].河北医药,2019,41(6):810-813.
[11] 廖强,王兆,刘静. 盐酸氢吗啡酮联合静脉泵镇痛对剖宫产产妇的镇痛效果及恢复情况的影响[J].中国性科学,2020,29(4):75-78.
[12] 刘幸清,凌晨,麦勤玲,等. 硬膜外腔单次注射吗啡联合地佐辛静脉自控镇痛对剖宫产产妇产后抑郁症和血清5-羟色胺水平的影响[J].海南医学,2018,29(9):1224-1227.
[13] 聂亮,胡芸,曾丽,等. 多模式镇痛方案下超声引导腰方肌阻滞与腹横肌平面阻滞对剖宫产产妇血压及胎儿内环境的影响[J].中国计划生育学杂志,2022,30(11):2504-2508.
[14] 孔德华,孔宪刚,王昆,等. 多模式镇痛方案下超声引导腰方肌阻滞与腹横肌平面阻滞在剖宫产术后快速康复中的效果比较[J].国际麻醉学与复苏杂志,2020,41(7):672-677. |
|
|
|
2026, Vol. 43 
