Clinical applicacation of ultrasound-guided abdomen nerve block combined with remifentanil infusion in cesarean section in patients with thrombocytopenia / 临床麻醉学杂志

ABSTRACT

Objective To observe the effect of ultrasound-guided abdomen nerve block combined with remifentanil infusion in cesarean section in patients with thrombocytopenia. Methods Sixty parturients recruited for the first cesarean delivery with thrombocytopenia (Plt<7.0 ×109/L),aged 20-32 years,in ASA physical status Ⅰ or Ⅱ,having no preterm birth and no fetal distress before surgery,were randomly divided into two groupstransversus abdominis plane block, ilioinguinal-iliohypogastric nerve block combined with remifentanil group (group T)and general anes-thesia group (group G).Both groups received patient-controlled intravenous analgesia (PCIA)after cesarean delivery;the delivery time from the cut to the fetus,Apgar score after delivery of the fetus, hemodynamics of the two groups of patients before surgery (T1 ),immediate cut (T2 )and fetal deliv-ery (T3 )and 48 h postoperative analgesic satisfaction were recorded and compared between the two groups.Results Compared with group G,the delivery time from the cut to the fetus was extended in group T (P < 0.05 ),but the fetus were removed within 6 minutes in the two groups.The Apgar score of 1 min after birth of newborns was significantly higher in group T than that in group G (P <0.05).Compared with group G,the blood pressure and the heart rate had increased at T3 in group T (P <0.05 ),but the parturients did not appear obvious symptoms.Compared with group G,the number of successfully delivered doses within 48 h were significantly lower in group T (P <0.05 ), TAP guided by sonography had excellent effect.Conclusion Ultrasound-guided abdomen nerve block combined with remifentanil infusion in cesarean section has little effect on neonatal,similar anesthesia effect to general anesthesia and obvious postoperative analgesia.