摘要
目的本研究旨在探索罗哌卡因切口和盆腔浸润复合布托啡诺用于妇科腹腔镜患者术后镇痛效果。方法本研究选择2021年1月-2022年4月在揭阳市慈云医院择期行气管插管全麻下腹腔镜手术患者60例,随机分为布托啡诺罗哌卡因组(RB组)、罗哌卡因组(R组)、布托啡诺组(B组),每组20例。三组患者均采用标准化气管插管静脉全身麻醉方案,手术结束前R组和RB组患者均由同一术科医师实施切口浸润复合盆腔内喷洒,使用0.2%罗哌卡因30mL(切口20mL,盆腔10mL),B组不进行切口和盆腔浸润。在手术结束时B组和RB组静脉注射布托啡诺1mg,R组静脉注射等量生理盐水。记录三组患者术后2h、4h、8h、12h、24h、48 h患者疼痛VAS评分;记录三组患者术中丙泊酚、舒芬太尼、瑞芬太尼用量;记录三组患者术后氟比洛芬酯镇痛例数、术后舒芬太尼镇痛例数;记录三组患者术后48h不良反应发生情况。结果与B组比较,RB组、R组术后2h、4h、8h、12h疼痛VAS评分明显降低(P<0.05),其中术后12h疼痛VAS评分RB组明显低于R组(P<0.05),术后2h、4h、8h RB组和R组疼痛VAS评分比较无明显差异(P>0.05),术后24h、48h疼痛VAS评分三组比较无明显差异(P>0.05),三组患者术中丙泊酚、舒芬太尼、瑞芬太尼用量比较无明显差异(P>0.05),与B组比较,RB组、R组氟比洛芬酯镇痛例数、舒芬太尼镇痛例数明显降低(P<0.05),其中RB组明显低于R组(P<0.05)。结论罗哌卡因切口和盆腔浸润复合布托啡诺静脉注射能安全有效用于妇科腹腔镜患者术后镇痛,效果优于罗哌卡因切口和盆腔浸润或布托啡诺静脉注射单独应用,降低术后疼痛评分,减少术后镇痛药物应用。
Objective The purpose of this study was to explore the analgesic effect of ropivacaine incision and pelvic infiltration combined with butorphanol in gynecological laparoscopic patients.Methods 60 patients undergoing elective endotracheal intubation and laparoscopic surgery under general anesthesia in Jieyang Ciyun hospital from January 2021 to April 2022 were randomly divided into butorphanol ropivacaine group(group RB),ropivacaine group(group R)and butorphanol group(group B),with 20 cases in each group.The three groups of patients were treated with standardized endotracheal intubation intravenous general anesthesia.Before the end of the operation,the patients in group R and group RB were treated with incision infiltration combined with pelvic spray by the same surgeon,using 30 mL of 0.2%ropivacaine(incision 20 mL,pelvic 10 mL),and group B was not treated with incision and pelvic infiltration.VAS scores of pain were recorded at 2h,4h,8h,12h,24h and 48h after operation.The intraoperative doses of propofol,sufentanil and remifentanil were recorded.The number of postoperative flurbiprofen axetil analgesia and sufentanil analgesia in the three groups were recorded.The adverse reactions of the three groups at 48 hours after operation were recorded.Results Compared with group B,the pain VAS scores of group RB and group R decreased significantly at 2h,4h,8h and 12h after operation(P<0.05),and the pain VAS scores of group RB at 12h after operation were significantly lower than those of Group R(P<0.05).There was no significant difference between group Rb and group R at 2h,4h and 8h after operation(P>0.05),and there was no significant difference among the three groups at 24h and 48h after operation(P>0.05).There was no significant difference in the dosage of propofol,sufentanil and remifentanil among the three groups(P>0.05).Compared with group B,the number of flurbiprofen axetil analgesia cases and sufentanil analgesia cases in RB group and group R were significantly lower(P<0.05),and the number of flurbiprofen axetil ana
作者
邹俊林
罗少波
王奇彦
张剑锋
ZOU Junlin;LUO Shaobo;WANG Qiyan;ZHANG Jianfeng(Department of Anesthesiology,Jieyang Ciyun Hospital,Jieyang,Guangdong,522000)
出处
《智慧健康》
2022年第32期116-120,共5页
Smart Healthcare
基金
揭阳市医学科学技术研究立项项目《罗哌卡因切口和盆腔浸润复合布托啡诺用于妇科腹腔镜患者术后镇痛的研究》(项目编号:[揭市卫(2021)57号240])。
关键词
罗哌卡因
切口浸润
盆腔浸润
布托啡诺
妇科腹腔镜
术后镇痛
Ropivacaine
Incision infiltration
Pelvic infiltration
Butorphano
Gynecological laparoscopy
Postoperative analgesia