Effect of ultrasound-guided anesthesia with different block anesthesia on postpartum analgesia and cellular immunity for HIV-infected pregnant women after cesarean section

Xu Xuewen; Li Shuiying; Cheng Mingjing; Zhao Weibing

doi:10.13406/j.cnki.cyxb.002945

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Effect of ultrasound-guided anesthesia with different block anesthesia on postpartum analgesia and cellular immunity for HIV-infected pregnant women after cesarean section

Clinical research | 更新时间：2022-11-09

- Effect of ultrasound-guided anesthesia with different block anesthesia on postpartum analgesia and cellular immunity for HIV-infected pregnant women after cesarean section
- Journal of Shanxi Agricultural Sciences Vol. 47, Issue 10, Pages: 1231-1235(2022)
- 作者机构：
  
  重庆市公共卫生医疗救治中心麻醉科，重庆　400036
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.002945
  CLC： R614.4
- Published：28 October 2022，
  
  Received：22 February 2021，
扫描看全文
Xu Xuewen, Li Shuiying, Cheng Mingjing, et al. Effect of ultrasound-guided anesthesia with different block anesthesia on postpartum analgesia and cellular immunity for HIV-infected pregnant women after cesarean section. [J]. Journal of Shanxi Agricultural Sciences 47(10):1231-1235(2022)
DOI：

Xu Xuewen, Li Shuiying, Cheng Mingjing, et al. Effect of ultrasound-guided anesthesia with different block anesthesia on postpartum analgesia and cellular immunity for HIV-infected pregnant women after cesarean section. [J]. Journal of Shanxi Agricultural Sciences 47(10):1231-1235(2022) DOI： 10.13406/j.cnki.cyxb.002945.

摘要

目的：

比较超声引导下腹横肌平面阻滞（transversus abdominis plane block，TAPＢ）镇痛和腰方肌阻滞（quadratus lumborum block，QLB）镇痛用于HIV感染孕产妇剖宫产术后镇痛效果及对细胞免疫的影响。

方法：

选择在重庆市公共卫生医疗救治中心接受剖宫产手术的HIV感染孕产妇60例，年龄22~32岁，体质指数（body mass index，BMI）18~25 kg/m

，ASAⅡ级。随机分为TAPB组和QLB组，每组30例。2组均采用腰-硬联合麻醉，术后行静脉自控镇痛（patient controlled intravenous analgesia，PCIA），QLB组术毕行超声引导下腰方肌阻滞，TAPB组行超声引导下腹横肌阻滞。记录术后4、8、12、24、36 h的静态VAS疼痛评分；术前1 d、术后1、2、3 d取外周血，检测白细胞介素（interleukin，IL）-2、IL-13、γ干扰素（interferon-γ，IFN-γ）浓度和CD3

、CD4

、CD8

含量及CD4

/CD8

；记录镇痛泵首次按压时间、术后补救性镇痛例数、一次穿刺成功率及不良麻醉反应。

结果：

与TAPB组术后4、8、12、24、36 h比较，QLB组各时间点静态VAS疼痛评分均明显降低（

0.05）。与TAPB组术后1、2、3 d比较，QLB组各时间点IL-2、IL-13、IFN-γ浓度和CD4

含量以及CD4

/CD8

均明显升高（

0.05）。QLB组镇痛泵首次按压时间明显晚于TAPB组，补救性镇痛率明显低于TAPB组（

0.05）。

结论：

HIV感染孕产妇剖宫产术后实施经腰方肌阻滞镇痛效果确切，能够减轻对细胞免疫的影响。

Abstract

Objective:

To study the analgesic effect of transversus abdominis plane block（TAPB） and quadratus lumborum block（QLB） on postpartum caesarean section of human immunodeficiency virus（HIV）-infected pregnant women and its influence on cellular immunity.

Methods:

Sixty HIV-infected pregnant women who underwent cesarean section in Chongqing Public Health Medical Center，aged 22-32，body mass index（BMI） 18-25 kg/m

，ASA Ⅱ. They were randomly divided into TAPB group and QLB group，with 30 cases in each group. Both groups were treated with combined spinal-epidural anesthesia，and underwent patient controlled intravenous analgesia（PCIA） after operation. The QLB group underwent ultrasound-guided bilateral QLB，and ultrasound-guided TAPB was conducted in TAPB group. The scores of resting VAS were recorded at 4 h，8 h，12 h，24 h，36 h after operation. The levels of interleukin（IL）-2，IL-13，interferon-γ（IFN-γ），CD3

，CD4

，CD8

and CD4

/ CD8

in peripheral blood were observed by 1 day before the operation and 1 day，2 days and 3 days after the operation. And the first compression time of the analgesic pump，the number of postoperative salvage analgesia cases，the success rate of one puncture and adverse anesthesia reactions.

Results:

Compared with the TAPB group at 4 h，8 h，12 h，24 h，and 36 h after surgery，the static VAS pain scores in the QLB group were significantly lower at each time point（

0.05）. Compared with the TAPB group 1 day，2 days and 3 days after the operation，the IL-2，IL-13，IFN-γ concentration，CD4

and CD4

/CD8

in the QLB group were significantly increased at each time point（

0.05）. The first compression time of the analgesic pump in the QLB group was significantly later than that in the TAPB group（

0.05），and the rate of remedial analgesia was significantly lower than that in the TAPB group（

0.05）.

Conclusion:

Post-operative cesarean section for HIV-infected pregnant women has better analgesia effect with QLB and can reduce the impact on the cellular immunity.

关键词

腰方肌阻滞腹横肌平面阻滞HIV感染孕产妇剖宫产术镇痛细胞免疫

Keywords

quadratus lumborum blocktransversus abdominis plane blockhuman immunodeficiency virus-infected pregnant womencaesarean sectionanalgesiacellular immunity

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