布托啡诺混合罗哌卡因竖脊肌平面阻滞对胸腔镜肺叶切除术患者术后转归的影响  

Effect of butorphanol mixed with ropivacaine for erector spinae plane block on postoperative outcomes in patients undergoing thoracoscopic pulmonary lobectomy

作　　者：张晓敏 贾彤[1] 姚杰[1] 李福龙[1] Zhang Xiaomin;Jia Tong;Yao Jie;Li Fulong(Department of Anesthesiology,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院麻醉科,张家口075000

出　　处：《中华麻醉学杂志》2021年第10期1189-1192,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价布托啡诺混合罗哌卡因竖脊肌平面阻滞(ESPB)对胸腔镜肺叶切除术患者术后转归的影响。方法择期全麻下行胸腔镜肺叶切除术患者80例,年龄35~64岁,BMI 19~30 kg/m^(2),性别不限,ASA分级Ⅰ或Ⅱ级。根据计算机生成的随机数字表分为2组(n=40):布托啡诺混合罗哌卡因ESPB组(EB组)和罗哌卡因ESPB组(E组)。2组均在超声引导下行ESPB。EB组注入0.1%布托啡诺1 ml和0.375%罗哌卡因的混合液20 ml,E组注入0.375%罗哌卡因20 ml。2组其他麻醉方法一致,均于缝皮结束时停止药物靶控输注并行PCIA。记录术中瑞芬太尼消耗量、首次按压镇痛泵时间、术后24 h内补救镇痛情况和ESPB有关并发症的发生情况。术后7 d时记录恢复质量-40(QoR-40)评分,于麻醉诱导前(T1)和术后24 h(T2)时采集外周静脉血样,测定血浆IL-6和IL-10浓度,行床旁肺功能检查并计算FEV1/FVC。结果与E组比较,EB组术后7 d时QoR-40评分升高,T2时FEV1/FVC升高,血浆IL-6浓度降低,IL-10浓度升高,术中瑞芬太尼消耗量减少,首次按压镇痛泵时间延长,术后24 h内补救镇痛率降低(P<0.05)。2组均未见ESPB有关并发症发生。结论布托啡诺混合罗哌卡因ESPB可促进胸腔镜肺叶切除术患者的术后转归。Objective To evaluate the effect of butorphanol mixed with ropivacaine for erector spinae plane block(ESPB)on postoperative outcomes in the patients undergoing thoracoscopic pulmonary lobectomy.Methods Eighty patients of either sex,aged 35-64 yr,with body mass index of 19-30 kg/m^(2),of American Society of Anesthesiologists physical statusⅠorⅡ,undergoing elective thoracoscopic pulmonary lobectomy,were divided into 2 groups(n=40 each)using a computer-generated random number table method:butorphanol mixed with ropivacaine for ESPB group(group EB)and ropivacaine for ESPB group(group E).ESPB was performed under ultrasound guidance in both groups.A mixture of 0.1%butorphano 1 ml and 0.375%ropivacaine 20 ml was injected in EB group,and 0.375%ropivacaine 20 ml was injected in E group.The other anesthesia methods were the same in the two groups.And target-controlled infusion was stopped and PCIA was performed at the end of skin suture in the two groups.The intraoperative consumption of remifentanil,first time to press an analgesia pump,requirement for rescue analgesia within 24 h after surgery,and occurrence of ESPB-related complications were recorded.Quality of Recovery-40(QoR-40)scores were recorded at 7 days after surgery.Before induction of anesthesia(T1)and at 24 h after operation(T2),the peripheral venous blood samples were collected for determination of plasma interleukin-6(IL-6)and IL-10 concentrations,and bedside pulmonary function test was performed,and FEV1/FVC was calculated.Results Compared with group E,the QoR-40 scores were significantly increased at 7 days after operation,FEV1/FVC was increased at T2,the plasma concentrations of IL-10 were decreased at T2,the plasma concentrations of IL-10 were increased at T2,the intraoperative consumption of remifentanil was reduced,the first time to press an analgesia pump was prolonged,and the requirement for rescue analgesia within 24 h after surgery was decreased in group EB(P<0.05).No ESPB-related complications were found in either group.Conclusion Butorphanol

关 键 词：布托啡诺 酰胺类 神经传导阻滞 胸腔镜检查 肺切除术 康复 

分 类 号：R614[医药卫生—麻醉学]