發(fā)布時(shí)間：2018-06-24 07:32

  本文選題：腹橫肌平面阻滯 + 羅哌卡因��； 參考：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年07期

【摘要】：目的對(duì)比不同濃度的羅哌卡因腹橫肌平面(transversus abdominis plane,TAP)阻滯用于腹腔鏡膽囊切除術(shù)(laparoscopic cholecystectomy,LC)患者術(shù)后的鎮(zhèn)痛效應(yīng)、整體轉(zhuǎn)歸和不良反應(yīng)。方法選擇蘭州大學(xué)第二醫(yī)院2015年11月至2016年5月?lián)衿谛蠰C的60例患者,采用隨機(jī)數(shù)字表法分為0.250%、0.375%濃度羅哌卡因組,每組30例。兩組患者均接受全憑靜脈麻醉和靶控輸注(target controlled infusion,TCI)下誘導(dǎo)和術(shù)中維持。手術(shù)開(kāi)始前,實(shí)施雙側(cè)超聲引導(dǎo)的TAP阻滯;手術(shù)結(jié)束前給予舒芬太尼維持鎮(zhèn)痛,轉(zhuǎn)運(yùn)至麻醉后恢復(fù)室和病房后,患者有疼痛主訴時(shí)給予帕瑞昔布鈉和舒芬太尼鎮(zhèn)痛。分別記錄術(shù)后首次使用額外鎮(zhèn)痛藥的時(shí)間、圍術(shù)期阿片類(lèi)藥物和帕瑞昔布鈉使用總量、術(shù)后不同時(shí)段的疼痛數(shù)字評(píng)分(numeric rating scale,NRS)以及相關(guān)的不良反應(yīng)。結(jié)果 LC術(shù)后兩組接受不同濃度的羅哌卡因行TAP阻滯的患者術(shù)中瑞芬太尼使用量比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后鎮(zhèn)痛藥用量、各時(shí)間點(diǎn)疼痛評(píng)分和相關(guān)的不良反應(yīng)比較,差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論低濃度羅哌卡因與高濃度相比鎮(zhèn)痛效果相當(dāng),建議降低濃度以提高TAP阻滯的安全性。
[Abstract]:Objective to compare the analgesic effect, overall outcome and adverse reaction of ropivacaine (transversus abdominis planetotap block in patients with laparoscopic cholecystectomy (LC). Methods 60 patients with LC from November 2015 to May 2016 in the second Hospital of Lanzhou University were randomly divided into 0.250 and 0.375% ropivacaine group with 30 cases in each group. Both groups received induction and intraoperative maintenance under total intravenous anesthesia and target-controlled infusion of (target controlled. Before operation, bilateral ultrasound guided tap block was performed, and sufentanil was administered to maintain analgesia before operation, and to be transferred to the recovery room and ward after anesthesia, the patients were given pareoxib sodium and sufentanil for analgesia when they had the main complaint of pain. The time of initial use of additional painkillers, the total amount of opioid and paroxib sodium used during perioperative period, the pain number score (numeric rating scale NRS) and the related adverse reactions were recorded respectively. Results there were significant differences in remifentanil usage between two groups of patients who received different concentrations of ropivacaine during tap block after LC (P0.05). The dosage of analgesics, pain score and related adverse reactions at different time points were compared between the two groups (P0.05). The difference was not statistically significant (P0.05). Conclusion the analgesic effect of low concentration ropivacaine is comparable to that of high concentration. It is suggested that the safety of tap block be improved by reducing the concentration of ropivacaine.
【作者單位】： 蘭州大學(xué)第二醫(yī)院麻醉科;康縣第一人民醫(yī)院消毒供應(yīng)室;
【分類(lèi)號(hào)】：R614.4

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