摘要
目的分析罗哌卡因阴部神经阻滞(PNB)应用于盆底重建术患者对术后镇痛及应激反应的影响。方法选取80例盆底重建手术患者为研究对象,按照随机数字表法将其分为对照组和研究组,各40例。对照组给予自控静脉镇痛(PCIA),研究组在对照组基础上给予罗哌卡因PNB。比较两组的临床效果。结果静息状态下,研究组术后6、12 h的视觉模拟评分法(VAS)评分显著低于对照组(P<0.05);活动状态下,研究组术后2、6、12 h的VAS评分显著低于对照组(P<0.05)。两组术后2、6、12、24、48 h的Ramsay评分比较,差异无统计学意义(P>0.05)。术后48 h,研究组的皮质醇(Cor)、血糖(BG)、去甲肾上腺素(NE)水平低于对照组(P<0.05)。术后48 h,研究组的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。术后6、12、24 h,研究组的Bruggrmann舒适度量表(BCS)评分高于对照组(P<0.05)。研究组的不良反应总发生率略低于对照组,但差异无统计学意义(P>0.05)。结论罗哌卡因PNB应用于盆底重建术患者中,具有较好的镇痛效果,可有效减轻疼痛程度、炎性反应和应激反应,增加舒适度。
Objective To analyze the effects of ropivacaine pudendal nerve block(PNB)on postoperative analgesia and stress response in patients undergoing pelvic floor reconstruction.Methods A total of 80 patients undergoing pelvic floor reconstruction operation were selected as the research objects and divided into control group and study group according to the random number table method,with 40 cases in each group.The control group was given patient-controlled intravenous analgesia(PCIA),and the study group was given ropivacaine PNB on the basis of the control group.The clinical effects of the two groups were compared.Results In the resting state,the Visual Analogue Scale(VAS)score of the study group at 6 and 12 h after operation were significantly lower than those of the control group(P<0.05);in the active state,the VAS score of the study group at 2,6 and 12 h after operation were significantly lower than those of the control group(P<0.05).There was no significant difference in Ramsay score between the two groups at 2,6,12,24,48 h after operation(P>0.05).At 48 h after operation,the levels of cortisol(Cor),blood glucose(BG)and noradrenaline(NE)in the study group were lower than those in the control group(P<0.05).At 48 h after operation,the levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in the study group were lower than those in the control group(P<0.05).At 6,12 and 24 h after operation,the Bruggrmann Comfort Scale(BCS)score of the study group was higher than that of the control group(P<0.05).The total incidence of adverse reactions in the study group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion Ropivacaine PNB has a good analgesic effect in patients undergoing pelvic floor reconstruction,which can effectively reduce the degree of pain,inflammatory and stress responses,and increase comfort.
作者
李延
王娜
贾亮
董石
LI Yan;WANG Na;JIA Liang;DONG Shi(Anesthesiology Department,Northwest Women's and Children's Hospital,Xi'an 710061;No.1 Obstetrics Department,521 Hospital of Norinco Group,Xi'an 710065;No.2 Gynecology Department,Northwest Women's and Children's Hospital,Xi'an 710061,China)
出处
《临床医学研究与实践》
2023年第36期21-24,41,共5页
Clinical Research and Practice
基金
陕西省卫生健康科研基金项目(No.2018D039)。
关键词
盆底重建术
罗哌卡因
阴部神经阻滞
术后镇痛
应激反应
pelvic floor reconstruction
ropivacaine
pudendal nerve block
postoperative analgesia
stress response
