Đánh giá tác dụng giảm đau sau phẫu thuật lấy thai của phương pháp gây tê cơ vuông thắt lưng hai bên liều duy nhất dưới hướng dẫn siêu âm với hỗn hợp ropivacain - dexamethason=Evaluation the analgesic effect after cesarean section by bilateral quadratus lumber block singer shot under ultrasound guidance with ropivacaine plus dexamethasone

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Tác giả: Xuân Huỳnh Đặng, Ngọc Trâm Nguyễn, Thu Thảo Trần, Văn Cường Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.148-154

Bộ sưu tập: Metadata

ID: 477710

Thêm vào giỏ

Đánh giá hiệu quả giảm đau sau phẫu thuật lấy thai của phương pháp gây tê cơ vuông thắt lưng hai bên liều duy nhất dưới hướng dẫn siêu âm với hỗn hợp ropivacain - dexamethason. Phương pháp nghiên cứu: Nghiên cứu được tiến hành trên 60 sản phụ được gây tê tủy sống mổ lấy thai chủ động tại Bệnh viện Phụ Sản Hà Nội, được giảm đau sau mổ bằng gây tê cơ vuông thắt lưng hai bên liều duy nhất dưới hướng dẫn siêu âm, chia ngẫu nhiên thành hai nhóm: Nhóm D sử dụng hỗn hợp 20ml ropivacain 0,2% + 1ml dexamethason (2mg) mỗi bên so với nhóm R sử dụng hỗn hợp 20ml ropivacain 0,2% + 1ml NaCl 0.9% mỗi bên. Kết quả: Nghiên cứu cho thấy gây tê cơ vuông thắt lưng hai bên (QLB) liều duy nhất với hỗn hợp Ropivain- Dexamethason có hiệu quả giảm đau tốt hơn so với sử dụng Ropivacain đơn thuần: điểm đau VAS khi nghỉ và khi vận động tại các thời điểm 48 giờ sau phẫu thuật của nhóm D đều thấp hơn nhóm R và đều dưới 4 điểm
thời gian giảm đau của nhóm D kéo dài hơn nhóm R có ý nghĩa thống kê (1083,8 phút với 610,67 phút
p<
0.05)
lượng morphin tiêu thụ trong 24 giờ đầu của nhóm D thấp hơn nhóm R có ý nghĩa thống kê (4,47 vs 7,4 mg, p<
0.05). Kết luận: Gây tê cơ vuông thắt lưng hai bên liều duy nhất dưới hướng dẫn siêu âm với hỗn hợp Ropivacain- dexamethason có tác dụng giảm đau tốt hơn so với Ropivacain đơn thuần.Evaluate the analgesic effect after cesarean section by bilateral quadratus lumber block single shot under ultrasound guidance with ropivacaine plus dexamethasone. Methods: The study was conducted on 60 women who received spinal anesthesia for elective cesarean section at Hanoi Obstetrics and Gynecology Hospital and received postoperative pain relief with a single dose of bilateral quadratus lumber block under ultrasound guidance. Patients were randomly divided into two groups: Group D received a mixture of 20ml ropivacaine 0.2% + 1ml dexamethasone (2mg) on each side compared with group R using a mixture of 20ml ropivacaine 0.2% + 1ml 0.9% NaCl on each side. Results: The study results showed that a single dose of Ropivain - Dexamethasone pain relief better than using Ropivacaine alone: VAS pain scores at rest and during exercise at 48 hours after surgery of group D were lower than group R and all less than 4 points
pain relief time of group D lasted longer than group R statistically significant (1083.8 minutes vs. 610.67 minutes
p<
0.05)
The amount of morphine consumed in the first 24 hours of group D was statistically significantly lower than that of group R (4.47 vs 7.4 mg, p<
0.05). Conclusion: Single dose bilateral quadratus lumber block under ultrasound guidance with Ropivacain- dexamethasone mixture has better analgesic than Ropivacaine alone.

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