Transverse abdominis Plane blocks (TAP) provide effective postoperative analgesia following surgical incisions of the lower and middle abdominal wall, including those associated with cesarean section. This study inves...Transverse abdominis Plane blocks (TAP) provide effective postoperative analgesia following surgical incisions of the lower and middle abdominal wall, including those associated with cesarean section. This study investigated the efficacy of liposomal bupivacaine diluted with 0.25% bupivacaine administered in bilateral TAP blocks for post-operative analgesia after Ce-sarean section preformed under neuraxial anesthesia. The patients who received the TAP blocks with liposomal bupivacaine had noticeably low pain scores of 1.0 ± 1.4, 1.4 ± 2.1, 1.7 ± 1.9, 1.9 ± 3.3 and 1.9 ± 2.3 at 6, 12, 24, 48 and 72 hours respectively. Only 3 patients used oxycodone (5 mg)/acetaminophen (325 mg) postoperative. One patient took two tables of oxycodone (5 mg)/acetamino-phen (325 mg) after 24 hours, a second patient used oxycodone (5 mg)/aceta-minophen (325 mg) after 72 hours and the third patient was transferred to the intensive care unit (ICU) since she developed postpartum cardiac complications, and was give oxycodone (5 mg)/acetaminophen (325 mg) despite having a 0 pain score. These results suggest that patients treated bilateral TAP blocks with a mixture of liposomal and regular bupivacaine will have low pain scores, high patient satisfaction and reduce the use of postoperative narcotics.展开更多
目的分析超声引导定位下椎管内麻醉联合腹横筋膜平面阻滞在肥胖孕妇剖宫产中的应用效果。方法将2022年6月至2025年2月期间在保定市妇幼保健院行剖宫产的82例肥胖孕妇使用双盲法设计分组,按随机数字表法分为常规组、联合组,每组各41例。...目的分析超声引导定位下椎管内麻醉联合腹横筋膜平面阻滞在肥胖孕妇剖宫产中的应用效果。方法将2022年6月至2025年2月期间在保定市妇幼保健院行剖宫产的82例肥胖孕妇使用双盲法设计分组,按随机数字表法分为常规组、联合组,每组各41例。常规组接受椎管内麻醉(常规髂嵴最高点连线定位法),联合组采用超声引导定位下椎管内麻醉联合腹横筋膜平面阻滞(剖宫产术后)。比较两组穿刺情况、术后疼痛[视觉模拟评分法(VAS)]评分、术后活动情况、术后恢复质量[40项恢复质量量表(QoR-40)]、术后并发症发生情况。结果联合组的穿刺次数为(1.29±0.57)次,少于常规组[(1.75±0.47)次],穿刺时间为(76.55±9.19)s,短于常规组[(111.04±13.35)s],差异均有统计学意义(P<0.05)。联合组术后2、6、12、24 h VAS评分均显著低于常规组,差异均有统计学意义(P<0.05)。联合组术后泌乳时间、住院时间均显著短于常规组,下床活动持续时间显著长于常规组,差异均有统计学意义(P<0.05)。联合组术后QoR-40评分中情绪状态等各方面评分及总分均显著高于常规组,差异均有统计学意义(P<0.05)。联合组术后并发症发生率为2.44%,显著低于常规组(19.51%),差异有统计学意义(P<0.05)。结论相比常规定位法,超声引导定位下椎管内麻醉联合腹横筋膜平面阻滞在肥胖孕妇剖宫产中的应用效果较好,可有效减少穿刺次数、优化镇痛效果、缩短泌乳时间、增加下床活动时间、加速术后康复并减少术后并发症。展开更多
This paper proposed a method of injection-production system adjustment to solve the problem that the water flooding effect was restricted because of the horizontal and vertical contradictions during the development pr...This paper proposed a method of injection-production system adjustment to solve the problem that the water flooding effect was restricted because of the horizontal and vertical contradictions during the development process of fault block reservoirs. Considering the heterogeneity of reservoir, the Buckley-Leverett water flooding theory was applied to establish the relationship between the recovery and cumulative water injection. In order to achieve the goal of vertically balanced recovery of each section, the calculation method of vertical sectional injection allocation was proposed. The planar triangular seepage unit was assumed and sweep coefficients of different oil-water distribution patterns were characterized using multi-flow tube method. In order to balance and maximize the plane sweep coefficient, the calculation method of plane production system optimization was obtained. Then the injection-production system stereoscopic adjustment method based on equilibrium displacement was proposed with vertical sectional injection allocation and plane production system optimization. This method was applied to injection and production adjustment of BZ oilfield in southern Bohai. The effect of water control and oil increase was obvious. This method can greatly improve the effect of water flooding of offshore fault block reservoirs with the adjustment of injection-production system.展开更多
文摘Transverse abdominis Plane blocks (TAP) provide effective postoperative analgesia following surgical incisions of the lower and middle abdominal wall, including those associated with cesarean section. This study investigated the efficacy of liposomal bupivacaine diluted with 0.25% bupivacaine administered in bilateral TAP blocks for post-operative analgesia after Ce-sarean section preformed under neuraxial anesthesia. The patients who received the TAP blocks with liposomal bupivacaine had noticeably low pain scores of 1.0 ± 1.4, 1.4 ± 2.1, 1.7 ± 1.9, 1.9 ± 3.3 and 1.9 ± 2.3 at 6, 12, 24, 48 and 72 hours respectively. Only 3 patients used oxycodone (5 mg)/acetaminophen (325 mg) postoperative. One patient took two tables of oxycodone (5 mg)/acetamino-phen (325 mg) after 24 hours, a second patient used oxycodone (5 mg)/aceta-minophen (325 mg) after 72 hours and the third patient was transferred to the intensive care unit (ICU) since she developed postpartum cardiac complications, and was give oxycodone (5 mg)/acetaminophen (325 mg) despite having a 0 pain score. These results suggest that patients treated bilateral TAP blocks with a mixture of liposomal and regular bupivacaine will have low pain scores, high patient satisfaction and reduce the use of postoperative narcotics.
文摘目的分析超声引导定位下椎管内麻醉联合腹横筋膜平面阻滞在肥胖孕妇剖宫产中的应用效果。方法将2022年6月至2025年2月期间在保定市妇幼保健院行剖宫产的82例肥胖孕妇使用双盲法设计分组,按随机数字表法分为常规组、联合组,每组各41例。常规组接受椎管内麻醉(常规髂嵴最高点连线定位法),联合组采用超声引导定位下椎管内麻醉联合腹横筋膜平面阻滞(剖宫产术后)。比较两组穿刺情况、术后疼痛[视觉模拟评分法(VAS)]评分、术后活动情况、术后恢复质量[40项恢复质量量表(QoR-40)]、术后并发症发生情况。结果联合组的穿刺次数为(1.29±0.57)次,少于常规组[(1.75±0.47)次],穿刺时间为(76.55±9.19)s,短于常规组[(111.04±13.35)s],差异均有统计学意义(P<0.05)。联合组术后2、6、12、24 h VAS评分均显著低于常规组,差异均有统计学意义(P<0.05)。联合组术后泌乳时间、住院时间均显著短于常规组,下床活动持续时间显著长于常规组,差异均有统计学意义(P<0.05)。联合组术后QoR-40评分中情绪状态等各方面评分及总分均显著高于常规组,差异均有统计学意义(P<0.05)。联合组术后并发症发生率为2.44%,显著低于常规组(19.51%),差异有统计学意义(P<0.05)。结论相比常规定位法,超声引导定位下椎管内麻醉联合腹横筋膜平面阻滞在肥胖孕妇剖宫产中的应用效果较好,可有效减少穿刺次数、优化镇痛效果、缩短泌乳时间、增加下床活动时间、加速术后康复并减少术后并发症。
文摘This paper proposed a method of injection-production system adjustment to solve the problem that the water flooding effect was restricted because of the horizontal and vertical contradictions during the development process of fault block reservoirs. Considering the heterogeneity of reservoir, the Buckley-Leverett water flooding theory was applied to establish the relationship between the recovery and cumulative water injection. In order to achieve the goal of vertically balanced recovery of each section, the calculation method of vertical sectional injection allocation was proposed. The planar triangular seepage unit was assumed and sweep coefficients of different oil-water distribution patterns were characterized using multi-flow tube method. In order to balance and maximize the plane sweep coefficient, the calculation method of plane production system optimization was obtained. Then the injection-production system stereoscopic adjustment method based on equilibrium displacement was proposed with vertical sectional injection allocation and plane production system optimization. This method was applied to injection and production adjustment of BZ oilfield in southern Bohai. The effect of water control and oil increase was obvious. This method can greatly improve the effect of water flooding of offshore fault block reservoirs with the adjustment of injection-production system.
