摘要
目的研究地塞米松复合罗哌卡因腹横腹横肌平面阻滞在腹腔镜胆囊切除术后的镇痛效果。方法 104例行腹腔镜胆囊切除术患者,由计算机随机分为研究组及对照组,各52例。研究组给予地塞米松复合罗哌卡因阻滞,对照组给予常规镇痛模式。比较两组患者的术后视觉模拟评分法(VAS)评分、恶心呕吐发生率、下床活动时间以及肠蠕动恢复时间。结果术后2、4 h,两组静息和运动VAS评分比较,差异无统计学意义(P>0.05);术后8、12、24 h,研究组静息和运动VAS评分均低于对照组,差异有统计学意义(P<0.05)。研究组术后恶心呕吐发生率7.69%低于对照组的23.08%,差异具有统计学意义(P<0.05)。研究组下床活动时间(19.87±1.92)h以及肠蠕动恢复时间(3.65±0.75)h短于对照组的(20.65±1.25)、(4.87±0.92)h,差异有统计学意义(P<0.05)。结论行腹腔镜胆囊切除术的患者采用地塞米松复合罗哌卡因阻滞可以改善患者手术后VAS评分、恶心呕吐发生率、下床活动时间以及肠蠕动恢复时间,患者在手术后可以得到更为完善的术后镇痛,适用于行腹腔镜胆囊切除术患者的临床推广,大面积使用可以提高地塞米松复合罗哌卡因阻滞的临床价值。
Objective To study the analgesic effect of dexamethasone combined with ropivacaine for ultrasound guided transversus abdominis plane block after laparoscopic cholecystectomy.Methods A total of 104 patients with laparoscopic cholecystectomy were divided into research group and control group according to computer random method,with 52 cases in each group.The research group received dexamethasone combined with ropivacaine for analgesia,and the control group received conventional analgesia.The postoperative visual analogue scale(VAS)score,occurrence of nausea and vomiting,off-bed activity time,and recovery time of bowel movement were compared between the two groups.Results At 2 and 4 h after surgery,there was no statistically significant difference in VAS scores at rest and exercise between the two groups(P>0.05).At 8,12 and 24 h after surgery,the VAS scores at rest and exercise of the research group were lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative nausea and vomiting 7.69%of the research group was lower than 23.08%of the control group,and the difference was statistically significant(P<0.05).The off-bed activity time(19.87±1.92)h and recovery time of bowel movement(3.65±0.75)h of the research group were shorter than(20.65±1.25)and(4.87±0.92)h of the control group,and the difference was statistically significant(P<0.05).Conclusion In patients undergoing laparoscopic cholecystectomy,the application of dexamethasone and ropivacaine block can improve the postoperative VAS score,the incidence of nausea and vomiting,off-bed activity time,and the recovery time of bowel movement.Patients can get more complete postoperative analgesia after surgery,which is suitable for clinical promotion of patients undergoing laparoscopic cholecystectomy,and large-scale use can improve the clinical value of dexamethasone combined with ropivacaine block.
作者
陈栋
曾朝阳
任燕
毛鹏
CHEN Dong;ZENG Chao-yang;REN Yan(Chongqing Iron and Steel General Hospital,Chongqing 400080,China)
出处
《中国实用医药》
2021年第22期116-118,共3页
China Practical Medicine
关键词
腹腔镜胆囊切除术
地塞米松
罗哌卡因
腹横肌平面阻滞
镇痛效果
Laparoscopic cholecystectomy
Dexamethasone
Ropivacaine
Transversus abdominis plan block
Analgesic effect
