摘要
目的:研究不同剂量的氢吗啡酮复合罗哌卡因腹横肌平面阻滞对妇科腹腔镜手术术后镇痛的影响。方法:选择拟在择期全麻下行妇科腔镜手术的患者120例,采用随机数表法将患者分为四组,四组罗哌卡因的浓度和剂量都相同,对照组(C组)加入生理盐水,实验组加入氢吗啡酮,分组为低剂量组(L组,0.25 mg氢吗啡酮)、中剂量组(M组,0.5 mg氢吗啡酮)、高剂量组(H组,1 mg氢吗啡酮)。全麻诱导后行双侧腹横肌平面阻滞。记录各组手术及拔管时间;术中镇痛及镇静药物的总量,术后8 h、12 h、24 h的静息及下床运动时镇痛评分(VAS),首次按压镇痛泵的时间及48 h内按压次数,术后恶心呕吐及皮肤瘙痒的发生率。结果:与C组相比,M组和H组在术中镇痛,镇静药物用量,术后镇痛泵按压次数,术后8 h、12 h、24 h的静息及运动时VAS评分均减少(P<0.05);且四组中M组术后拔管用时最短(P<0.05);M组和H组首次按压镇痛泵时间明显延长(P<0.05);M组术后不良反应的发生率低于C组(P<0.05)。结论:氢吗啡酮复合罗哌卡因腹横肌平面阻滞能有效减少术中镇痛镇静药用量,延长镇痛时间,减少术后不良反应发生率,0.5 mg的氢吗啡酮剂量较为有效。
Objective:To study the effect of different doses of hydromorphone combined with ropivacaine on postoperative analgesia in gynecological laparoscopic surgery.Methods:120 patients scheduled for gynecological endoscopic surgery under general anesthesia were randomly divided into 4 groups.The concentrations and doses of ropivacaine in the four groups were the same.The control group(Group C)was added with normal saline,and the experimental group was treated with hydromorphone.The patients were divided into low-dose group(Group L,0.25 mg hydromorphone),medium dose group(group M,0.5 mg hydromorphone)and high-dose group(Group H,1 mg hydromorphone).After induction of general anesthesia,bilateral transverse abdominis plane block was performed.The operation and extubation time,the total amount of analgesic and sedative drugs during operation,the analgesia score(VAS)at rest and out of bed movement at 8 h,12 h and 24 h after operation,the time of first pressing the analgesia pump and the times of pressing in 48 h,the incidence of postoperative nausea and vomiting and skin itching were recorded.Results:Compared with group C,group M and group H had less intraoperative analgesia,sedative drug dosage,postoperative analgesia pump pressing times,resting and exercise VAS scores at 8 h,12 h,24 h after operation(P<0.05),and group M had the shortest extubation time(P<0.05).The time of first pressing analgesia pump in group M and group H was significantly prolonged(P<0.05),and the incidence of postoperative adverse reactions in group M was lower than that in group C(P<0.05).Conclusion:Hydromorphone combined with ropivacaine can effectively reduce the amount of sedative,prolong the analgesic time and reduce the incidence of postoperative adverse reactions.The dosage of 0.5 mg hydromorphone is more effective.
作者
杜新华
李斯羽
姜丽华
DU Xinhua;LI Siyu;JIANG Lihua(Department of Anesthesiology,Harbin Medical University Cancer Hospital,Heilongjiang Harbin 150000,China.)
出处
《现代肿瘤医学》
CAS
北大核心
2022年第15期2818-2821,共4页
Journal of Modern Oncology
关键词
氢吗啡酮
腹横肌平面阻滞
妇科腔镜手术
hydromorphone
transverse abdominal plane block
gynecological endoscopic surgery
