罗哌卡因竖脊肌神经阻滞辅助全身麻醉用于腰椎手术30例  

Ropivacaine Erector Spinae Plane Block Assisting General Anesthesia in Lumbar Spine Surgery of 30 Cases

作　　者：余奇劲[1] 郭咸希[2] YU Qijing;GUO Xianxi(Department of Anesthesiology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Pharmacy,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院麻醉科,武汉430060 [2]武汉大学人民医院药学部,武汉430060

出　　处：《医药导报》2018年第1期63-66,共4页Herald of Medicine

摘　　要：目的观察罗哌卡因竖脊肌神经阻滞辅助全身麻醉用于腰椎手术的临床效果。方法择期全身麻醉下行腰椎手术的男性患者60例,随机分为竖脊肌神经阻滞组(E组)和对照组(C组)(n=30)。C组直接全凭静脉麻醉,E组于切皮前行0.375%罗哌卡因竖脊肌阻滞。记录手术中患者生命体征、手术节段、手术时间、麻醉时间、麻醉药物用量及手术者对肌肉松弛的满意度。手术后4,8,24,48 h时行视觉模拟评分(VAS),并记录手术后48 h内补救镇痛药物使用情况、患者自控静脉镇痛(PCIA)按压次数、恶心呕吐等并发症和患者对麻醉满意程度情况。结果两组患者手术中生命体征、手术节段、手术时间、麻醉时间及手术后并发症等均差异无统计学意义(均P>0.05)。C组和E组丙泊酚用量分别为(1 526.2±134.5),(1 305.8±212.8)mg;瑞芬太尼用量分别为(2 452.2±232.5),(2 076.8±311.6)μg;苯磺顺阿曲库铵用量分别为(31.8±4.2),(22.3±5.1)mg(P<0.05或P<0.01)。手术者对E组手术区域肌肉松弛满意度明显提高(P<0.05)。E组手术后4,8 h静息切口VAS评分均显著降低(均P<0.01),手术后48 h内补救镇痛药物使用次数(或总量)和PCIA按压次数均显著减少(P<0.01),患者对麻醉的满意程度明显提高(P<0.01)。结论罗哌卡因竖脊肌神经阻滞辅助全身麻醉用于腰椎手术,可以减少围手术期全身麻醉药物用量和手术后补救镇痛药物使用次数及PCIA的按压次数,提高手术中手术医生和手术后患者麻醉满意度。ObjectiveTo observe the clinical effect of ropivacaine erector spinae plane block assisting general anesthesia in lumbar spine surgery.MethodsA total of60cases of male patients with selective lumbar spine surgery under general anesthesia were chosen and randomly divided into control group(group C)and erector spinae plane block group(group E)(n=30).Group C was directly treated with total intravenous anesthesia.In group E,the erector spinae were blocked with0.375%ropivacaine before skin incision.The patient's vital signs during operative period were recorded,as well as the operation time,anesthesia time,drug dosage and satisfaction of muscle relaxation.Postoperative VAS scores at4,8,24and48h were recorded.Remedied analgesic drug use,the number of PCIA press,complications such as nausea and vomiting,patients’satisfaction degree within48h of postoperative were all recorded.ResultsThere were no statistical difference in the vital signs,operation section,operation time,anesthesia time and postoperative complications(all P>0.05)in two groups.Compared with group C,the dosage of propofol,rifentanyl and benzene sulfonate in group E were significantly reduced.In group C and group E,dosage of propofol was(1526.2±134.5)mg and(1305.8±212.8)mg;dosage of remifentanil was(2452.2±232.5)μg and(2076.8±311.6)μg;dosage of benzene sulfonate was(31.8±4.2)mg and(22.3±5.1)mg](P<0.05or P<0.01).Satisfaction of muscle relaxation in the operation area of group E was significantly increased(P<0.05).The VAS scores at4h and8h after operation in group E were all significantly reduced(P<0.01).In group E,the frequency(or total)of remediation analgesic drugs usage and PCIA compressions times were significantly reduced in48h after surgery(P<0.01).The satisfaction degree of the patients in group E was significantly increased(P<0.01).ConclusionRopivacaine erector spinae plane block assisting general anesthesia in lumbar spine surgery can reduce perioperative general anesthesia drug dosage,the number of postoperative remediation of analgesic d

关 键 词：罗哌卡因 竖脊肌神经阻滞 患者自控静脉镇痛 

分 类 号：R971.2[医药卫生—药品] R614.4[医药卫生—药学]