罗哌卡因和利多卡因在腹股沟疝手术中的效果对比  

Comparison of the effects of local anesthesia with ropivacaine and lidocaine in inguinal hernia surgery

作　　者：侯化梅 华东 Hou Huamei;Hua Dong(Department of Anesthesiology,Ma'anshan Central Hospital,Ma'anshan 243000,China)

机构地区：[1]马鞍山中心医院麻醉科,安徽省243000

出　　处：《中华疝和腹壁外科杂志（电子版）》2021年第1期48-52,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：安徽省高校省级自然科学研究项目(KJ20132144)。

摘　　要：目的探讨罗哌卡因和利多卡因在腹股沟疝手术中局部麻醉的效果差异。方法选择2018年1月至2019年11月在马鞍山中心医院接受腹股沟疝无张力修补手术治疗的患者90例。30例使用利多卡因局部麻醉的患者作为A组,30例使用利多卡因联合0.375%罗哌卡因的患者作为B组,30例使用利多卡因联合0.75%罗哌卡因的患者作为C组。对比3组的血流动力学指标[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))]、手术情况相关指标(手术耗时、失血量、住院时间)、麻醉效果相关指标[麻醉起效时间、麻醉持续时间、术后患者的视觉模拟评分(VAS)]、术后不良反应。结果3组患者在麻醉前、麻醉后1、5、10 min的MAP、HR、SpO_(2)数据差异无统计学意义(P>0.05)。3组患者的手术耗时、失血量数据差异无统计学意义(P>0.05)。B组和C组的住院时间短于A组(P<0.05)。B组和C组的麻醉起效时间长于A组(P<0.05)。C组的麻醉持续时间长于B组,B组的麻醉持续时间长于A组(P<0.05)。C组在术后1、3、6、9 h的VAS评分低于B组,B组在术后1、3、6、9 h的VAS评分低于A组(P<0.05)。3组在术后12、24 h的VAS评分差异无统计学意义(P>0.05)。3组的术后不良反应差异无统计学意义(P>0.05)。结论对于接受腹股沟疝无张力修补手术的患者,采用含有利多卡因或者罗哌卡因的局部麻醉方法均可以保证手术过程中的血流动力学稳定以及麻醉效果。利多卡因的起效时间更快,罗哌卡因的镇痛效果维持时间更长,使用浓度为0.75%罗哌卡因与利多卡因联合使用,患者可获得更好的术后镇痛效果,且用药的安全性良好。Objective To explore the difference in the effect of local anesthesia between ropivacaine and lidocaine in inguinal hernia surgery.Methods From January 2018 to November 2019,90 patients who underwent tension-free inguinal hernia repair at Ma'anshan Central Hospital were selected.Thirty patients underwent local anesthesia with lidocaine served as group A,30 patients underwent local anesthesia with lidocaine combined with 0.375%ropivacaine as group B,and 30 patients underwent local anesthesia with lidocaine combined with 0.75%ropivacaine as group C.The hemodynamic indexes of the 3 groups[mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO_(2))before anesthesia,1 min after anesthesia,5 min after anesthesia,10 min after anesthesia],related indexes of the operation condition(operating time,blood loss,length of hospital stay),anesthesia effect related indicators[anesthesia onset time,anesthesia duration,postoperative visual analogue scale(VAS)at 1,3,6,9,12,and 24 hours],postoperative adverse reactions were compared among the three groups.Results The differences in MAP,HR and SpO_(2) data of the three groups of patients before anesthesia,1 minute after anesthesia,5 minutes after anesthesia,and 10 minutes after anesthesia were not statistically significant(P>0.05).There were no statistically significant differences in operating time and blood loss among the three groups of patients(P>0.05).The hospital stay of group B and group C was shorter than that of group A(P<0.05).The onset time of anesthesia in group B and group C was longer than that in group A(P<0.05).The duration of anesthesia in group C was longer than that in group B,and the duration of anesthesia in group B was longer than that in group A(P<0.05).The VAS score of group C at 1,3,6 and 9 hours after operation was lower than that of group B,and the VAS score of group B at 1,3,6,and 9 hours after operation was lower than that of group A(P<0.05).There was no significant difference in the VAS score data among the 3 groups at 12 and 24 hours afte

关 键 词：罗哌卡因 利多卡因 疝 腹股沟 无张力疝修补术 麻醉 

分 类 号：R614[医药卫生—麻醉学]