摘要
目的:探讨罗哌卡因联合右美托咪定切口浸润对腹腔镜胆囊切除术后患者镇痛效果和睡眠质量的影响。方法:选取某院2018年1月~2020年10月行腹腔镜手术治疗的患者90例作为研究对象,采用随机数字表法分为研究组(罗哌卡因联合右美托咪定进行切口局部浸润麻醉镇痛)和对照组(罗哌卡因进行切口局部浸润麻醉镇痛),每组45例,比较两组患者术后恢复情况、术后(3、12、24h和48h)切口疼痛程度、术前(PSG1)、术后(PSG2和PSG3)睡眠质量及不良反应发生情况。结果:研究组术后3、12、24h和48h的疼痛视觉模拟评分法(VAS)评分均低于对照组,局部浸润麻醉镇痛持续时间长于对照组,术后48h内静脉镇痛药物用量少于对照组(P<0.05)。研究组首次排气时间、首次进食时间、首次下床时间、术后住院时间均短于对照组(P<0.05)。与PSG1比较,两组患者PSG2和PSG3的N3期和REM期睡眠减少,觉醒指数升高,主观睡眠质量降低(P<0.05)。与对照组比较,研究组PSG2和PSG3的N1期睡眠减少、N2期睡眠增多,觉醒指数降低,主观睡眠质量升高(P<0.05)。不良反应总发生率组间比较无统计学差异(P>0.05)。结论:罗哌卡因联合右美托咪定行切口浸润应用于腹腔镜胆囊术后镇痛可安全有效地改善镇痛效果、改善睡眠剥夺,并促进患者术后康复。
Objective:To investigate the effect of ropivacaine combined with dexmedetomidine incision infiltration on postoperative analgesia and sleep quality in patients undergoing laparoscopic cholecystectomy.Methods:A total of 90 patients who underwent laparoscopic surgery in a hospital from January 2018 to October 2020 were selected and divided into study group(n=45,ropivacaine combined with dexmedetomidine for incisional local infiltration anesthetic analgesia)and control group(n=45,ropivacaine for incisional local infiltration anesthetic analgesia)by random number table method.The changes in postoperative recovery,postoperative(3,12,24h and 48h)pain degree of incisions,preoperative(PSG1)and postoperative(PSG2 and PSG3)sleep quality and incidence of adverse reactions were compared between the two groups.Results:The visual analogue scale(VAS)scores of pain in the study group were lower than those of the control group at 3,12,24h and 48h postoperatively,the duration of local infiltration anesthetic analgesia was longer than that of the control group,and the consumption of intravenous analgesic drugs within 48 hours postoperatively was less than that of the control group(P<0.05).The time to the first exhaust,the time to first taking food,the time to get out of bed for the first time,and the postoperative length of stay in the study group were shorter than those in the control group(P<0.05).Compared with PSG1,the N3 and REM phases of PSG2 and PSG3 in both groups showed decreased sleep,increased arousal index,and lower subjective sleep quality(P<0.05).Compared with the control group,PSG2 and PSG3 showed decreased sleep in N1 phases and increased sleep in N2 phases,decreased arousal index and higher subjective sleep quality in the study group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between groups(P>0.05).Conclusion:Incision infiltration of ropivacaine combined with dexmedetomidine for postoperative analgesia after laparoscopic cholecystectomy can safely and effect
作者
李焕丽
冯凤喜
李印玉
郝静娴
韩劲松
LI Huan-li;FENG Feng-xi;LI Yin-yu;HAO Jing-xian;HAN Jin-song(Department of Anesthesiology,Zhoukou Central Hospital,Zhoukou 466000,China)
出处
《中国合理用药探索》
2023年第4期121-127,共7页
Chinese Journal of Rational Drug Use
基金
河南省科技厅科技攻关重点推广项目(192102310127)。
关键词
罗哌卡因
右美托咪定
切口浸润
腹腔镜
术后镇痛
ropivacaine
dexmedetomidine
incision infiltration
laparoscopy
postoperative analgesia
