Clinical Application Of Ultrasound-Guided Bilateral Transversus Abdominis Plane (TAP) Block For Caesarean Section Under General Anesthesia

ObjectiveTo evaluate the efficacy of ultrasound-guided bilateral transversus abdominis plane block(TAP)before cesarean section under general anesthesia in reducing the dosage of general anesthetics,reducing the effect of general anesthetics on neonates and enhancing the analgesic effect after operation.MethodsSixty patients,aged 20-43yr,weighing 48-100kg,of American Society of Anesthesiologists physical I or II,scheduled for elective cesarean section under genera]anesthesia,were divided into 2 groups(n?30 each)by using a random number table:transversus abdominis plane block group(group T)and control group(group C).In group T,transversus abdominis plane block with 0.375%ropivacaine 20 ml in both sides was performed under the guidance of ultrasound before induction of anesthesia.All patients received routine monitoring.Anesthesia was induced with intravenous propofol 2 mg/kg,remifentanil 1 il g/kg and rocuronium 0.6 mg/kg.Adjust the remifentanil dosage to maintain heart rate and blood pressure fluctuate within 20%of the base value.Bispectral index value was maintained at 40-60.All the patients received patient-controlled intravenous analgesia with sufentanil after operation,and visual analogue scale was maintained<4 within 48h after operation.When visual analogue scale?4,tramadol 50mg was injected intravenouslyas rescue analgesic.The I-D[induction-delivery)]interval and the dosage of remifentanil during I-D interval,Apgar scores at 1,5 and 10 minutes,the neurological and adaptive capacity scores(NACS)scores at 24,48,72h,VAS scores,the consumption of PCIA within 24h and 48h and requirement for rescue analgesics after surgery,the adverse reactions in 48h after operation and the time for colostrum were recorded.Results1.There were no significant differences in age,height,weight,gestational week,fetal weight,ASA classification,I-D interval,operation time and bleeding volume between the two groups(P>0.05];2.There was no significant difference in NACS scores after operation between the two groups(P>0.05);3.Compared with group C,the consumption of remifentanil,the amount of drugs consumed during PCIA within 24h and 48h after operation were significantly decreased,the Apgar scores at lmin was higher,the time for colostrum was earlier in group T(P<0.05);4.Compared with group C,the incidence of somnolence and the rate of rescue analgesics were significantly decreased in group T(P<0.05).ConclusionUltrasound-guided bilateral transversusabdominis plane block used for cesarean section before anesthesia induction can reduce the dosage of remifentanil before delivery of the fetus,reduce neonatal inhibitionand and enhance postoperative analgesia and promote early lactation of maternal.