本文選題：淋巴靜脈吻合術(shù)　切入點：氟比洛芬酯　出處：《中國微創(chuàng)外科雜志》2017年03期

【摘要】：目的探討羅哌卡因和氟比洛芬酯用于繼發(fā)性上肢淋巴水腫患者淋巴靜脈吻合術(shù)后的鎮(zhèn)痛效果。方法2014年10月~2016年3月,選擇全麻淋巴靜脈吻合術(shù)45例,隨機分為羅哌卡因組(R組)、氟比洛芬酯預(yù)處理組(F_1組)和氟比洛芬酯后處理組(F_2組)各15例。R組在手術(shù)結(jié)束時應(yīng)用0.2%羅哌卡因10 ml局部浸潤麻醉切口,F_1組于麻醉誘導(dǎo)前5 min靜注氟比洛芬酯100 mg,F_2組于手術(shù)結(jié)束前5 min靜注氟比洛芬酯100 mg。記錄術(shù)后1、2、6、12、24和48 h的疼痛視覺模擬評分(visual analogue scale,VAS)和追加鎮(zhèn)痛藥的例數(shù)。結(jié)果術(shù)后2 h時R組靜息痛和運動痛VAS均低于F_1組、F_2組[靜息痛(3.4±0.7)分vs.(4.2±0.9)分vs.(4.1±1.0)分,F=3.741,P=0.032;運動痛(3.7±0.6)分vs.(4.6±0.9)分vs.(4.4±1.0)分,F=4.305,P=0.020];術(shù)后6 h時R組靜息痛VAS低于F_1組、F_2組[(2.7±0.5)分vs.(3.4±0.5)分vs.(3.1±0.6)分,F=5.783,P=0.006]。術(shù)后2 h時R組需要使用鎮(zhèn)痛藥的患者例數(shù)少于F_1和F_2組(1例vs.7例vs.5例,χ~2=6.058,P=0.048)。結(jié)論淋巴靜脈吻合術(shù)后羅哌卡因局部浸潤麻醉能取得較好的術(shù)后鎮(zhèn)痛效果。
[Abstract]:Objective to investigate the analgesic effect of ropivacaine and flurbiprofen in patients with secondary upper limb lymphedema. Methods from October 2014 to March 2016, 45 patients with lymphovenous anastomosis under general anesthesia were selected. They were randomly divided into ropivacaine group (n = 15), flurbiprofen preconditioning group (n = 15), flurbiprofen group (n = 15) and flurbiprofen post-treatment group (n = 15). Group R (n = 15) received 0.2% ropivacaine 10 ml local invasive anesthesia at the end of operation. 5 min before induction, flurbiprofen ester 100mg / F stack was injected intravenously 5 min before operation in group 2. Visual analogue scores (visual analogue scaleVASs) and additional analgesics were recorded at 1: 2 and 48 h after operation. Results at 2 h after operation, R. The VAS of rest pain and exercise pain in group F1 was lower than that in group F1 (3.4 鹵0.7 vs.(4.2 鹵0.9) vs.(4.1 鹵1.0); in group R (3.7 鹵0.6) vs.(4.6 鹵0.9 vs.(4.6 鹵1.0) vs.(4.4 鹵1.0; VAS in group R was lower than that in group F1 at 6 h after operation [2.7 鹵0.5 vs.(3.4 鹵0.5 vs.(3.1 鹵0.6]. The number of patients treated with analgesics was less than that in group F _ 1 and F _ 2 with vs.5 (蠂 ~ 2 6.058). Conclusion ropivacaine local infiltration anesthesia after lymphatic vein anastomosis can obtain better postoperative analgesic effect.
【作者單位】： 首都醫(yī)科大學(xué)附屬世紀(jì)壇醫(yī)院麻醉科;
【分類號】：R614.2

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