平行侧入法硬膜外穿刺CSEA对剖宫产术后腰背痛的影响

目的:探讨平行侧入法硬膜外穿刺腰硬联合麻醉对剖宫产术后腰背痛的影响。方法:选择2014年10月至2016年9月在我院行剖宫产的产妇95例,将其随机分为两组。对照组45例,产妇接受平行直入法硬膜外穿刺腰硬联合麻醉,观察组50例产妇接受平行侧入法硬膜外穿刺麻醉。比较两组产妇术后宫缩、伤口、腰背疼痛VAS评分、术中穿刺情况、术后使用镇痛泵的有效按压次数及术后3 d、7 d、14 d和2个月后腰背疼痛的情况。结果:观察组产妇术后宫缩、伤口以及腰背疼痛评分、术后使用镇痛泵的有效按压次数均显著低于对照组(P0.05),且术中一次性穿刺成功率显著高于对照组(P0.05),且术后7 d、14 d以及2个月腰背痛的发生率显著低于对照组(P0.05)。结论:平行侧入穿刺法行腰硬联合麻醉可有效提高剖宫产产妇一次穿刺成功率,显著缓解产妇的术后疼痛,并降低术后腰背疼痛的发生率。

Effect of Epidural Puncture with Paralleling Side on the Postoperative Low Back Pain of Patients with Cesarean Section Undergoing CSEA

ABSTRACT Objective: To explore the effect of epidural puncture with paralleling side on the postoperative low back pain of patients with cesarean section undergoing combined spinal epidural anesthesia. Methods: 95 patients with cesarean section were enrolled in our hospital from October 2014 to September 2016 were selected and divided into two groups, the control group (n=45) accepted epidural puncture with paralleling straight method for combined spinal epidural anesthesia, and the study group (n=50) adopted anesthesia with paralleling side puncture. The VAS scores of uterine contraction, incision pain and low back pain, condition of puncture, effective pressing for analgesia pump and the incidence of low back pain on the 3rd, 7th, 14th day and at the 2nd month after operation were compared between two groups. Results: The VAS scores of uterine contraction, incision pain and low back pain of study group were significantly lower than those of the control group (P<0.05), and the puncture success rate with one-time of patients of study group was remarkably higher than that of the control group(P<0.05). The times of effective pressing for analgesia pump in study group was significantly fewer than that of the control group (P<0.05), and the incidence of low back pain on the 3rd, 7th, 14th day and at the 2nd month after operation were lower than those of the control group(P<0.05). Conclusion: Epidural puncture with paralleling side method for cesarean section patients undergoing combined spinal epidural anesthesia not only increased the puncture success rate with one-time, but also remarkably relieved the postoperative pain of parturient women and decreased the incidence of postoperative low back pain.