【摘要】：目的研究羅哌卡因的局部浸潤麻醉對(duì)腰椎間盤切除術(shù)后患者切口疼痛的影響。方法選擇在我院接受全麻性腰椎間盤切除術(shù)患者120例作為研究對(duì)象,并根據(jù)患者麻醉方式的不同將其分為三組,每組各含患者40例。A組患者在實(shí)施麻醉后、切皮前應(yīng)用腎上腺素和0.25%的羅哌卡因逐層浸潤切口皮下、肌層等;B組患者在實(shí)施麻醉后、切皮前,應(yīng)用腎上腺素和0.9%的生理鹽水逐層浸潤切口皮下、肌層等;C組患者不實(shí)施局部浸潤麻醉處理。對(duì)三組患者手術(shù)后2h、4h、6h、8h以及12h安靜時(shí)患者的疼痛視覺模擬評(píng)分進(jìn)行詳細(xì)記錄,同時(shí)記錄手術(shù)后12h、24h額外鎮(zhèn)痛藥的人數(shù)、患者的傷口愈合情況以及患者睡眠質(zhì)量情況。結(jié)果 A組患者手術(shù)后6h、8h、12h的疼痛視覺模擬評(píng)分明顯低于其他兩組,(P0.05)差異有統(tǒng)計(jì)學(xué)意義;A組患者手術(shù)后12h、24h要求給予額外鎮(zhèn)痛藥的人數(shù)明顯低于B組與C組,睡眠質(zhì)量明顯優(yōu)于B組與C組,(P0.05),差異存在統(tǒng)計(jì)學(xué)意義。三組患者在手術(shù)時(shí)間、手術(shù)后的拆線時(shí)間無明顯差異,均未有傷口感染患者(P0.05)。結(jié)論羅哌卡因局部浸潤麻醉用于腰間盤切除術(shù)中,能夠有效的提升鎮(zhèn)痛效果,保障患者睡眠質(zhì)量,減少患者額外鎮(zhèn)痛藥的使用量,臨床應(yīng)用價(jià)值顯著。
[Abstract]:Objective to study the effect of ropivacaine local infiltration anesthesia on incision pain after lumbar discectomy. Methods 120 patients undergoing general anesthesia discectomy in our hospital were selected and divided into three groups according to different anesthetic methods, each group consisted of 40 patients. Before skin incision, epinephrine and 0.25% ropivacaine were used to infiltrate subcutaneously and muscularly. The patients in group B were treated with epinephrine and 0.9% of normal saline to infiltrate subcutaneously and muscularly respectively before skin incision, while patients in group C were not treated with local infiltration anesthesia. The visual analogue scores of pain were recorded at 2 h, 4 h, 6 h, 8 h and 12 h after operation, and the number of additional painkillers at 12 h and 24 h after operation were recorded. Wound healing and sleep quality. Results the visual analogue score of pain in group A was significantly lower than that in the other two groups (P 0.05). The number of patients in group A who required extra analgesic at 12 hours after operation was significantly lower than that in group B and group C, and the sleep quality was significantly better than that in group B and group C (P0.05). There was no significant difference between the three groups in the time of operation and the time of removing thread after operation. There was no wound infection in all patients (P0.05). Conclusion Local invasive ropivacaine anesthesia for lumbar discectomy can effectively improve the analgesic effect, ensure the sleep quality of patients, reduce the use of additional analgesic drugs, and the clinical application value is significant.
【作者單位】： 中國人民解放軍第92醫(yī)院麻醉科;
【分類號(hào)】：R614

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