Abstract：Objective To explore the application value of ultrasound-guided transversal abdominis plane (TAP) block in combined spinal-epidural anesthesia of cesarean section.Methods Sixty puerpera who underwent cesarean section with combined spinal and epidural anesthesia from March 2017 to March 2018 admitted to our hospital were divided into experimental group and control group according to the random number table method,with 30 cases in each group.The control group was given combined spinal-epidural anesthesia + traditional TAP block anesthesia,while the experimental group was given combined spinal-epidural anesthesia + ultrasound-guided TAP block.The heart rate,mean arterial pressure and pain score (visual analogue scale [VAS]score) before the incision,at the time of delivery and at the end of the operation of the two groups were compared.The pain scores at 2,4,8,16,24,and 36 h after surgery of the two groups were compared.The occurrence of intraoperative traction reaction,adverse reactions (nausea and vomiting)of the two groups were compared.The number of times that the analgesic pump was pressed,and the time required for the first time to go to the ground of the two groups were compared.Results The heart rate,mean arterial pressure and VAS scores of the experimental group were lower than those of the control group before skin incision,at the time of fetal delivery and at the end of the operation,and the differences were statistically significant (P<0.05).There was no significant difference in VAS score between the two groups 2 h after operation (P>0.05).The VAS scores of the experimental group at 4,8,16,24,36 h after delivery were lower than those of the control group,the differences were statistically significant (P<0.05).The incidence of traction reaction and adverse reactions during operation in the experimental group were lower than those in the control group,the number of times that the analgesic pump was pressed was fewer than that in the control group,and the time required for the first time to go to the ground was shorter than that in the control group,the differences were statistically significant (P<0.05).ConclusionUltrasound-guided TAP block is more effective in cesarean section combined with spinal and epidural anesthesia.It can effectively reduce the incidence of adverse reactions and relieve postoperative pain,thus it is worthy of promotion and application.
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