摘要
目的探讨不同浓度罗哌卡因在开放无张力腹股沟疝修补术中的应用及术后镇痛效果的差异。方法选择2020年1月至2022年6月,濉溪县医院行开放式无张力腹股沟疝手术的患者78例为研究对象行前瞻性研究。以随机数字表法分成对照组和观察组,各39例。2组患者均采用超声引导下髂腹股沟神经阻滞联合腹直肌鞘阻滞。对照组应用0.2%罗哌卡因,观察组应用0.3%罗哌卡因。观察2组不同时点血流动力学指标、疼痛视觉模拟评分(VAS)、麻醉不良反应发生率、血清应激反应指标(肾上腺素、去甲肾上腺素、皮质醇)变化。结果2组患者在手术前,切皮时,术后2 h的平均动脉压、心率、血氧饱和度差异无统计学意义(P>0.05)。观察组术后2 h、6 h、12 h VAS评分均低于对照组(P<0.05)。2组术后均未出现麻醉不良反应。血清应激反应指标2组术前0.5 h差异无统计学意义(P>0.05),观察组术后2 h、8 h均低于对照组(P<0.05)。结论开放性腹股沟疝修补手术,采用超声引导下髂腹股沟神经阻滞及腹直肌鞘阻滞的方法,应用不同浓度的罗哌卡因均可以较好地维持手术中的麻醉效果,但是0.3%罗哌卡因更利于患者术后早期镇痛,降低人体应激反应程度,且没有增加药物不良反应风险。
Objective To investigate the application of ropivacaine with different concentrations in open tension-free inguinal hernia repair and the difference in postoperative analgesia.Methods From January 2020 to June 2022,78 patients who underwent inguinal hernia surgery at Suixi County Hospital were prospectively collected for the study.They were divided into a control group and an observation group according to the random number table method,with 39 cases in each group.The patients in both groups were treated with ultrasound-guided iliac inguinal nerve blocks and rectus abdominis sheath blocks.In the control group,0.2%ropivacaine was applied,and in the observation group,0.3%ropivacaine was applied.Changes in hemodynamic indexes,the postoperative visual analogue score(VAS),the incidence of adverse reactions to anesthesia,and serum stress indexes(epinephrine,norepinephrine,and cortisol)were compared and observed in the two groups at different time points.Results There was no statistically significant difference in mean arterial pressure,heart rate and blood oxygen saturation between the two groups before surgery,at the time of skin incision,and 2 hours after surgery(P>0.05).The VAS scores were lower in the observation group than in the control group at 2h,6h,and 12h postoperatively(P<0.05).There was no statistically significant difference between the 2 groups at 0.5 h postoperatively(P>0.05).no adverse anesthetic reaction occurred in the 2 groups after surgery.There was no statistically significant difference in serum stress index between the 2 groups at 0.5h preoperatively(P>0.05),and the observation group was lower than the control group at 2h and 8h postoperatively(P<0.05).Conclusion In open inguinal hernia repair surgery,ultrasound-guided ilioinguinal nerve block and rectus abdominis sheath block were used,and the application of different concentrations of ropivacaine could better maintain the anesthetic effect during surgery,but 0.3%ropivacaine facilitated early postoperative analgesia,reduced the degree of the human stress response,and did not increase the risk of adverse drug reactions.
作者
孙邦峰
崔振华
马斌
Sun Bangfeng;Cui Zhenhua;Ma Bin(Department of Anesthesiology,Suixi County Hospital,Suixi,235000,Anhui,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2023年第1期65-69,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
安徽省重点研究和开发计划项目(201904a07020012)
关键词
罗哌卡因
神经阻滞
镇痛
疝
腹股沟
麻醉
Ropivacaine
Nerve block
Analgesia
Hernia,inguinal
Anesthesia
作者简介
通信作者:孙邦峰,Email:sbf20160626@163.com
