摘要
目的探讨罗哌卡因和氟比洛芬酯用于继发性上肢淋巴水肿患者淋巴静脉吻合术后的镇痛效果。方法2014年10月~2016年3月,选择全麻淋巴静脉吻合术45例,随机分为罗哌卡因组(R组)、氟比洛芬酯预处理组(F_1组)和氟比洛芬酯后处理组(F_2组)各15例。R组在手术结束时应用0.2%罗哌卡因10 ml局部浸润麻醉切口,F_1组于麻醉诱导前5 min静注氟比洛芬酯100 mg,F_2组于手术结束前5 min静注氟比洛芬酯100 mg。记录术后1、2、6、12、24和48 h的疼痛视觉模拟评分(visual analogue scale,VAS)和追加镇痛药的例数。结果术后2 h时R组静息痛和运动痛VAS均低于F_1组、F_2组[静息痛(3.4±0.7)分vs.(4.2±0.9)分vs.(4.1±1.0)分,F=3.741,P=0.032;运动痛(3.7±0.6)分vs.(4.6±0.9)分vs.(4.4±1.0)分,F=4.305,P=0.020];术后6 h时R组静息痛VAS低于F_1组、F_2组[(2.7±0.5)分vs.(3.4±0.5)分vs.(3.1±0.6)分,F=5.783,P=0.006]。术后2 h时R组需要使用镇痛药的患者例数少于F_1和F_2组(1例vs.7例vs.5例,χ~2=6.058,P=0.048)。结论淋巴静脉吻合术后罗哌卡因局部浸润麻醉能取得较好的术后镇痛效果。
Objective To explore the analgesic effect of ropivacaine and flurbiprofen for patients with secondary upper extremity lymphedema after lymphatic venous anastomosis. Methods A total of 45 cases of lymphatic venous anastomosis under general anesthesia between October 2014 and March 2016 were randomly allocated to 3 groups： ropivacaine group（ group R）,flurbiprofen preprocessing group（ group F1）,and flurbiprofen postprocessing group（ group F2）,with 15 cases in each group. Local infiltration anesthesia was made with 0. 2% ropivacaine 10 ml at the incision before the end of operation in the group R. The flurbiprofen 100 mg was intravenously injected at 5 minutes before the induction of anaesthesia in the group F1 and 5 minutes before the end of operation in the group F2. The visual analogue scale（ VAS） scores and the number of patients using analgesics after operation at1,2,6,12,24 and 48 h were recorded. Results The rest pain and movement pain VAS scores at postoperative 2 h were lower in the group R than those in the group F1 and F2[rest pain：（ 3. 4 ± 0. 7） points vs.（ 4. 2 ± 0. 9） points vs.（ 4. 1 ± 1. 0） points,F =3. 741,P = 0. 032; movement pain：（ 3. 7 ± 0. 6） points vs.（ 4. 6 ± 0. 9） points vs.（ 4. 4 ± 1. 0） points,F = 4. 305,P = 0. 020].The rest pain VAS scores at postoperative 6 h were lower in the group R than those in the group F1 and F2[（ 2. 7 ± 0. 5） points vs.（ 3. 4 ± 0. 5） points vs.（ 3. 1 ± 0. 6） points,F = 5. 783,P = 0. 006]. The number of patients requiring analgetics was lower in the group R than that in the group F1 and F2at postoperative 2 h（ 1 case vs. 7 cases vs. 5 cases,χ~2= 6. 058,P = 0. 048）. Conclusion Local anesthesia with ropivacaine in patients after lymphatic venous anastomosis can achieve good postoperative analgesia.
出处
《中国微创外科杂志》
CSCD
北大核心
2017年第3期245-248,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
淋巴静脉吻合术
氟比洛芬酯
罗哌卡因
术后镇痛
Lymphatic venous anastomosis
Flurbiprofen
Ropivacaine
Postoperative analgesia
