罗哌卡因混合麻醉液在切开法重睑成形术中的应用研究  

Study on the Application of Ropivacaine Mixed Anesthetic in Blepharoplasty with Incision Method

作　　者：柴宁 褚燕军[1] 赵李平[1] 王明刚[1] CHAI Ning;CHU Yan-jun;ZHAO Li-ping;WANG Ming-gang(Department of Plastic and Burn Surgery,Anhui Provincial Hospital of Anhui Medical University,Hefei 230001,Anhui,China)

机构地区：[1]安徽医科大学附属安徽省立医院整形外科,安徽合肥230001

出　　处：《中国美容医学》2020年第7期11-14,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究1%利多卡因-肾上腺素(1:200000)和1%利多卡因-0.375%罗哌卡因-肾上腺素(1:1:200000)在切开法重睑成形术中、术后镇痛效果,以及术中出血、术后肿胀情况。方法:采取前瞻性、双盲、自身对照方法,在2019年1月-2019年7月笔者医院门诊行双侧切开法重睑成形术的患者中选取40例,随机在其一侧眼睑中注射1%利多卡因-肾上腺素(1:200000),另一侧眼睑则使用1%利多卡因-0.375%罗哌卡因-肾上腺素(1:1:200000),由另一名医师记录患者在术后即刻、术后2h、6h、10h、1d、2d疼痛评分,以及术中出血评分,术后1d肿胀评分。结果:使用1%利多卡因-0.375%罗哌卡因-肾上腺素(1:1:200000)作为麻醉液的眼睑术后2h、6h、10h、1d的疼痛感觉评分显著低于1%利多卡因-肾上腺素组(1:200000),差异有统计学意义(P<0.05);而患者双侧眼睑术后即刻、术后2d的疼痛感觉及术中出血评分和术后1d肿胀评分比较,差异无统计学意义(P>0.05)。结论:在切开法重睑成形术中,使用1%利多卡因-0.375%罗哌卡因-肾上腺素(1:1:200000)与1%利多卡因-肾上腺素(1:200000)相比,可以显著延长患者术后的镇痛时间,提升患者的舒适感和满意度,值得在临床推广应用。Objective To explore the difference of intraoperative and postoperative anesthesia effect,intraoperative bleeding score and postoperative swelling score between 1%lidocaine-adrenalin(1:200000)mixture and 1%lidocaine-0.375%ropivacaine-adrenalin(1:1:200000)mixture in blepharoplasty with incision method.Methods A prospective,randomized and self-control study was conducted.A total of 40 patients who received the bilateral double eyelid operation with the incision method were selected from January 2019 to July 2019.We injected 1%lidocaine-adrenaline(1:200000)in one side of the eyelid randomly,the other side of the eyelid was injected with 1%lidocaine-0.375%ropivacaine-adrenaline(1:1:200000).Another surgeon recorded the pain scores of the patients immediately after surgery,and then repeated the assessment at 2h,6h,10h,1d and 2d postoperative.The intraoperative bleeding scores and swelling scores on 1d after surgery were evaluated as well.Results The postoperative pain score of the eyelid injected with 1%lidocaine 0.375%ropivacaine-adrenaline(1:1:200000)was significantly lower than those in 1%lidocaine-adrenaline(1:200000)side eyelid in 2h,6h,10h,1d after surgery,the differences were statistically significant(P<0.05).There was no significant difference in the pain score of bilateral palpebra in the immediate period after surgery and 2d postoperative,the intraoperative bleeding score and postoperative swelling score between the two eyelids(P>0.05).Conclusion Compared with 1%lidocaine-adrenalin(1:200000),1%lidocaine-0.375%ropivacaine-adrenalin(1:1:200000)not only can significantly reduce patients'postoperative pain sensation but also can increase the comfort level and the satisfaction of patients in bilateral double eyelid operation.Thereby,this method can be applied further in clinical practices.

关 键 词：重睑成形术 切开法 罗哌卡因 自身对照 前瞻性 双盲实验 

分 类 号：R622[医药卫生—整形外科]