| Objective:To investigate the occurrence of injection site pain and analgesic effect with ultrasound-guided quadratus lumborum block and transversus abdominis plane block after cesarean delivery.Methods:Ninety pregnant women undergoing caesarean section were included in the study.Bilateral TAPB or QLB guided by ultrasound were performed randomly.All pregnant women received combined spinal epidural anesthesia and patient-controlled intravenous analgesia pump after the surgery.The pain site,occurrence of ISP,pain onset time,and degree of incision pain and uterine contraction pain at 6,12,16,20,24 and 48 hours in resting state were recorded.The total pressing times of intravenous analgesia pump within 24 hours,whether there was analgesic remedy(diclofenac 100mg),and whether there were adverse reactions such as intestinal exhaust,drowsiness,nausea,vomiting and chills 24 hours after operation were recorded.Results:A total of 86 pregnant female subjects were finally included in the study,with 43 cases in each group.Eighteen parturients had injection site pain,The incidence of ISP mentioned by maternal in TAPB group was 32.6%,which was significantly higher than 9.3% in QLB group(P < 0.01).There was no significant difference in the resting VAS score of surgical incision and contractions between ISP positive and ISP negative patients in both groups(P> 0.05).In addition,at 12 h,16h and 20 h after operation,the VAS score of incision pain,the total pressing times of intravenous analgesia pump within 24 hours and analgesic remedy rate in QLB group was significantly lower than that TAPB group(P < 0.05).However,there was no significant difference in the incidence of adverse reactions and uterine contraction pain and adverse reactions between the two groups(P> 0.05).Conclusion:Compared with the TAPB,the QLB has lower incidence of ISP and better analgesic effect on postoperative incision pain within 48 h,but no significant difference in uterine contraction pain. |
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