中国医科大学学报

中国医科大学学报
  • 中文核心期刊
  • 中国科技核心期刊
  • 中国高校百佳科技期刊
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (2): 162-166.doi: 10.12007/j.issn.0258-4646.2018.02.015

• 论著 • 上一篇    下一篇

胰十二指肠切除术后罗哌卡因切口局部浸润的镇痛效果

阴俊, 张锦   

  1. 中国医科大学附属盛京医院麻醉科, 沈阳 110004
  • 收稿日期:2017-03-09 出版日期:2018-02-28 发布日期:2018-01-11
  • 通讯作者: 张锦 E-mail:zhangj_sj@163.com
  • 作者简介:阴俊(1990-),女,硕士研究生.

Effect of Ropivacaine Incision Infiltration of Local Anesthesia on Postoperative Pain Relief in Pancreaticoduodenectomy

YIN Jun, ZHANG Jin   

  1. Deparment of Aneathesiology, Shengjing Hospital, China Medical University, Shenyang 110004, china
  • Received:2017-03-09 Online:2018-02-28 Published:2018-01-11

摘要: 目的 探在胰十二指肠切除术后罗哌卡因切口局部浸润的镇痛效果。方法 将择期行胰十二指肠切除术患者40例随机分为罗哌卡因(R)组和对照(C)组。患者均被告知并签署知情同意书。R组开腹后和关腹前分别用0.5%罗哌卡因(20 mL)在壁层腹膜和腹直肌前鞘局部浸润麻醉,拔管后连接静脉自控镇痛泵。C组开腹后和关腹前不给予罗哌卡因注射,拔管后连接静脉自控镇痛泵。记录术后拔管后即刻(T0)舒芬太尼用量、Ramsay评分,记录围拔管期的平均动脉压(MAP)、心率(HR),记录各时刻VAS评分和静脉镇痛泵的有效按压次数及术后不良反应发生情况。结果 术后R组T0时舒芬太尼用量,Ramsay评分,苏醒后2、4、12 h VAS评分,有效按压次数及不良情况明显优于C组(均P < 0.01)。结论 切口局部浸润镇痛效果确切,可提高术后苏醒期安全性,因此,罗哌卡因切口局部浸润在胰十二指肠切除术后应用安全、有效,值得推广。

关键词: 切口局部浸润, 胰十二指肠切除术, 罗哌卡因

Abstract: Objective To evaluate the feasibility of postoperative ropivacaine incision infiltration of local anesthesia in pancreaticoduodenectomy.Methods Forty patients undergoing pancreaticoduodenectomy were randomized into two groups:control (C) group and ropivacaine (R) group,with 20 patients in each group. The patients in group C did not receive any treatment after the abdomen was opened,and before the abdomen was closed,they received ropivacaine twice. The patients in group R received 20 mL of 0.5% ropivacaine local infiltration after the abdomen was opened,and before the abdomen was closed,they received ropivacaine twice. After extubation,patients in both groups were connected to a patient controlled analgesia (PCA) pump;the requirements of sufentanil and Ramsay sedation score were recorded at time T0 (after extubation). Visual analog scores (VAS) and the time of PCA were also recorded at 2,4,12,24,and 48 h post operation. Evacuation time and adverse effect rate were also compared.Results The requirements of sufentanil in group R were significantly lower than those in group C at T0 (P < 0.01). VAS and the time of PCA in group R were significantly lower than those in group C at 2,4,and 12 h after operation (P < 0.01).Conclusion Local anesthesia can increase the analgesic effect and the safety of postoperative revival period;therefore,ropivacaine incision infiltration of local anesthesia can be safely and efficiently used in pancreaticoduodenectomy.

Key words: incision infiltration of local anesthesia, pancreaticoduodenectomy, ropivacaine

中图分类号: 

  • R614.2
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