摘要
目的观察罗哌卡因浸润麻醉对全髋关节置换术老年患者全麻恢复期应激反应的影响。方法将72例行全髋关节置换术老年患者随机分为观察组(36例)和对照组(36例),对照组给予全麻,观察组在全麻的基础上给予罗哌卡因浸润麻醉(术毕时)。检测比较两组的平均动脉压(MAP)、心率(HR)、血清皮质醇和血糖水平。采用视觉模拟评分法(VAS)评估两组术后的疼痛程度。结果观察组的MAP和HR在拔管时、拔管5 min和拔管10 min时均明显低于对照组(P<0.05);在手术结束后30 min、术后第1与第2天清晨的皮质醇和血糖水平明显低于对照组(P<0.01);术后2、4、8、12、24 h时的VAS评分均明显低于对照组(P<0.05)。结论在全髋关节置换术中,罗哌卡因浸润麻醉可使患者的生命体征更加平稳,同时可明显减轻患者术后疼痛程度,并有效减轻患者的应激反应。
Objective To investigate the effect of infiltration anesthesia with ropivacaine on relieving stress reaction in the elderly patients with total hip replacement.Methods Seventy-two elderly patients with total hip replacement were randomly divided into Observation Group（36 cases）and Control Group（36 cases）.The Control Group was given general anesthesia while the Observation Group was given infiltration anesthesia with ropivacaine on the basis of general anesthesia（at the end of the surgery）.The mean arterial pressure（MAP）,heart rate（HR）,serum cortisol concentration and blood glucose levels were measured and compared between the two groups.Visual analogue scale（VAS）was used to assess and compare the postoperative pain between the two groups.Results The MAP and HR of the Observation Group were significantly lower than those of the Control Group during the extubation,5 min after extubation and 10 min after extubation（P〈0.05）.The levels of cortisol and blood glucose of the Observation Group were significantly lower than those in the Control Group 30 min after the surgery,the early morning of postoperative Day 1 and Day 2（P〈0.01）.The VAS score of the Observation Group was significantly lower than that of the Control Group at postoperative 2,4,8,12 and 24h（P〈0.05）.Conclusion The infiltration anesthesia with ropivacaine during the total hip replacement can make the vital signs of the patients more stable,significantly relieve the postoperative pain of the patients and effectively reduce the stress response of the patients.
作者
方创茂
许炎荣
邱晓涛
李创光
FANG Chuang-mao, XU Yan-rong, QIU Xiao-tao, LI Chuang-guang(Department of Anesthesiology, Puning Overseas Chinese Hospital, Puning 515300, Chin)
出处
《广东医科大学学报》
2017年第5期555-558,共4页
Journal of Guangdong Medical University
