一次性使用术后局部麻醉镇痛系统用于胸科手术术后镇痛的临床观察  

Clinical observation of the single use local anesthesia for analgesia system for thoracic surgery patients during postoperative period

作　　者：贺显建[1] 程燕玲[1] 高岚[1] 

机构地区：[1]解放军第323医院麻醉科,陕西西安710054

出　　处：《中国现代医学杂志》2015年第4期87-90,共4页China Journal of Modern Medicine

摘　　要：目的 观察一次性使用术后局部麻醉镇痛系统用于胸科手术患者术后的镇痛效果和安全性。方法选择胸科手术患者40例,ASAⅠ∽Ⅱ级,随机分为两组,每组20例。A组采用自控静脉镇痛（PCIA）,芬太尼1mg、氟哌利多5mg,加生理盐水至100 ml;B组一次性使用术后局部麻醉镇痛系统经伤口局部输注0.375%罗哌卡因;观察术后2、4、8、12、24和48 h时视觉模拟评分（VAS）、舒适度评分（BCS）、镇静评分（Ramsay）,以及术后不良反应的发生情况和患者切口愈合情况。结果 两组患者切口愈合情况比较差异无统计学意义（〉0.05）;术后8 h内,B组镇静、镇痛效果和舒适度明显优于A组（〈0.05）,术后8 h后,镇静、镇痛强度和舒适度两组无明显差异（〉0.05）,但术后不良反应发生情况A组明显高于B组（〈0.05）。结论 胸科手术患者术后一次性使用术后局部麻醉镇痛系统具有良好的镇痛效果与安全性,副作用少,且有利于患者术后充分配合治疗和早期活动,促进早期康复。[ Objective ] To observe the effect and safety of the single use local anesthesia for analgesia system for thoracic surgery patients during post-operative period. [ Method ] An observational study was undertaken with 40 scheduled thoracic surgery patients, ASA I-II, randomly divided into two groups-Group A and Group B, each group with 20 patients. Group A patients used Patient-controlled intravenous analgesia （PCIA）, with lmg of Fentanyl, 5mg of Droperidol, added into 100 ml of normal saline; Group B used the Single Use Local Anesthesia for Analgesia Sys- tem by local injection of 0.375% of Ropivacaine at the surgery site, and then post-operative observation was carried out based on Visual Analog Scale（VAS）, Basic Comfort Scale（BCS）, Ramsay Score, as well as postoperative untoward reaction occurrence and surgical wound healing of the patients every 2 hr, 4 hr, 8 hr, 12 hr, 24 hr, and 48 hours. [ Result ] Compared to the surgical wound healing condition, there were no statistical significance （P 〉0.05） between the two groups; Within 8 hours of post-operative period, both sedation and analgesia effect along with comfort level of Group B were significantly better than Group A （P 〈0.05）, after 8 hours of post-operative period, there were no significant difference of sedation and analgesia effect and comfort level between Group A and Group B （P 〉0.05）. However, the side effect occurrence rate of Group A was higher than Group B （P 〈0.05）. [ Conclusion] Thoracic surgery patients received Single Use Local Anesthesia for Analgesia System had better analgesia effect and safety, less side effect. It is useful for patients to be cooperative on post-operative treatments and had positive influence on early ambulation of post-operative rehabilitation, in order to promote early recovery to thoracic surgery patients.

关 键 词：麻醉和镇痛 胸科手术 罗哌卡因 

分 类 号：R614.3[医药卫生—麻醉学]