摘要
目的 探讨布比卡因脂质体用于超快通道麻醉(UFTA)对心脏手术患者术后镇痛效果及早期恢复效果的影响。方法 选取2023年3月至2025年3月在河南省胸科医院行心脏手术104例患者为研究对象,采用随机数字表法分为对照组(布比卡因局部浸润麻醉)和试验组(布比卡因脂质体局部浸润麻醉),各52例。两组术中均采用超快通道心脏麻醉,对照组采用布比卡因局部浸润麻醉,试验组术中采用布比卡因脂质体局部浸润麻醉,比较两组术前(T0)、术后6 h(T_(1))、术后12 h(T_(2))、术后24 h(T_(3))、术后48 h(T_(4))的视觉模拟评分法(VAS)评分、血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))],早期恢复情况(术后48 h阿片类药物使用量、ICU住院时间、总住院时间)以及不良反应发生率。结果 两组患者疼痛评分的时间、组间及交互比较,差异均有统计学意义(P<0.05),试验组T_(1)至T_(4)时,疼痛评分均低于同期对照组(P<0.05)。两组患者HR、SpO_(2)的时间、组间及交互比较,差异均有统计学意义(P<0.05),MAP时间、组间比较,差异均有统计学意义(P<0.05),交互比较,差异无统计学意义(P>0.05)。试验组T_(2)至T_(4)时HR低于同期对照组,差异有统计学意义(P<0.05),T_(2)、T_(4)时MAP高于同期对照组,差异均有统计学意义(P<0.05),T_(1)至T_(4)时SpO_(2)高于同期对照组,差异均有统计学意义(P<0.05)。试验组术后48 h阿片类药物使用量低于对照组,差异均有统计学意义(P<0.05),两组ICU住院时间、总住院时间比较,差异无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 在心脏手术患者UFTA中采用布比卡因脂质体局部浸润麻醉可有效稳定血流动力学指标,降低术后疼痛评分和阿片类药物使用量,且安全性良好。
Objective To investigate the effects of liposomal bupivacaine used in ultra-fast-track anesthesia(UFTA)postoperative analgesia and early recovery in patients undergoing cardiac surgery.Methods A total of 104 patients undergoing cardiac surgery at Henan Provincial Chest Hospital from March 2023 to March 2025 were enrolled.Patients were randomly divided into a control group(local infiltration anesthesia with bupivacaine)and an experimental group(local infiltration anesthesia with liposomal bupivacaine),with 52 patients in each group.Both groups received ultrashort pathway cardiopulmonary anesthesia.The control group received bupivacaine for local infiltration anesthesia,while the experimental group received liposomal bupivacaine for local infiltration anesthesia.The study compared preoperative(T0),postoperative 6 hours(T_(1)),12 hours(T_(2)),24 hours(T_(3)),and 48 hours(T_(4))visual analogue scale(VAS)scores,hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2))],early recovery indicators[postoperative 48-hour opioid consumption,ICU stay duration,total hospital stay],and incidence of adverse reactions.Results There were statistically significant differences in pain scores over time,between groups,and in interaction effects(P<0.05).At T_(1) to T_(4),pain scores in the experimental group were lower than those in the control group(P<0.05).Significant differences in HR and SpO₂over time,between groups,and their interaction effects were observed(P<0.05).For MAP,significant differences over time and between groups were found;interaction effects were not statistically significant(P>0.05).At T_(2) to T_(4),the experimental group had lower HR than the control group(P<0.05),higher MAP at T_(2) and T_(4) compared to the control group(P<0.05),and higher SpO₂at T_(1) to T_(4)(P<0.05).The 48-hour postoperative opioid consumption was lower in the experimental group than in the control group(P<0.05).No significant differences were observed between groups in ICU stay duration and total hospitalization time(P>0.05).The incidence of adverse reactions was comparable between groups(P>0.05).Conclusion The use of liposomal bupivacaine for local infiltration anesthesia in UFTA for cardiac surgery patients effectively stabilizes hemodynamic parameters,reduces postoperative pain scores and opioid consumption,and demonstrates good safety.
作者
孟睿
周俊辉
钟巍
刘晓乐
MENG Rui;ZHOU Junhui;ZHONG Wei;LIU Xiaolei(Department of Anaesthesia,Henan Provincial Chest Hospital,Zhengzhou Henan 450008,China)
出处
《临床研究》
2025年第7期93-96,共4页
Clinical Research
关键词
超快通道麻醉
心脏手术
布比卡因脂质体
术后镇痛
早期恢复
ultra-fast-track anesthesia
cardiac surgery
liposomal bupivacaine
postoperative analgesia
early recovery
作者简介
孟睿,女。研究方向:盐酸戊乙奎醚对胸腔镜下肺癌根治术患者术后恶心呕吐的影响;通讯作者:周俊辉,副主任医师,zhoujunhui1985@126.com。
