甲磺酸罗哌卡因与左旋布比卡因在疝囊高位结扎术超声引导腹横肌平面阻滞中的应用比较  

Comparison of the application of ropivacaine and levobupivacaine in ultrasound-guided transversus abdominis plane block during high ligation of hernia sac

作　　者：童卫国 孙桂珍 TONG Weiguo;SUN Guizhen(Department of Anesthesiology,Hanchuan People's Hospital,Hubei,Xiaogan 431600,China)

机构地区：[1]湖北省孝感汉川市人民医院麻醉科,431600

出　　处：《临床外科杂志》2022年第6期535-538,共4页Journal of Clinical Surgery

摘　　要：目的观察超声引导腹横肌平面阻滞下甲磺酸罗哌卡因与左旋布比卡因在疝囊高位结扎术中的镇痛效果及安全性。方法2018年3月~2020年3月我院收治的腹股沟疝患儿133例,按神经阻滞药物分为甲磺酸罗哌卡因组(RP组)与左旋布比卡因组(LB组),RP组62例,LB组71例。比较两组临床指标、镇痛效果[儿童疼痛行为量表(FLACC)]及安全性。结果两组患儿拔管时间、苏醒时间及住院时间比较,差异无统计学意义(P>0.05),LB组瑞芬太尼用量低于RP组,差异有统计学意义(P<0.05)。两组患儿术后4小时(T_(1))FLACC评分高于术后即刻(T_(0))、术后12小时(T_(2))及术后24小时(T_(3))时点,差异有统计学意义(P<0.05);且LB组T_(1)、T_(2)时点FLACC评分均低于RP组,差异有统计学意义(P<0.05)。两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论超声引导下的甲磺酸罗哌卡因或左旋布比卡因用于腹横肌平面阻滞在小儿疝囊高位结扎术均有良好的镇痛效果,左旋布比卡因的镇痛强于甲磺酸罗哌卡因,两者安全性相当。Objective To observe the analgesic effect and safety of ropivacaine and levobupivacaine in high ligation of hernia sac under ultrasonography guided transversus abdominis plane block.Methods A retrospective study was conducted on 133 children with inguinal hernia admitted to our hospital from March 2018 to March 2020.Nerve block drugs were divided into two groups:ropivacaine group(RP group)and levobupivacaine group(LB group),with 62 cases in RP group and 71 cases in LB group.Clinical indexes,analgesic effect(FLACC)and safety were compared.Results There were no significant differences in extubation time,recovery time and hospitalization time between the two groups(P>0.05),and the dosage of remifentanil in LB group was significantly lower than that in RP group(P<0.05).The FLACC score at T_(1) was significantly higher than that at T_(0),T_(2) and T_(3)(P<0.05).The FLACC scores of LB group at T_(1) and T_(2) were significantly lower than those of RP group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The ultrasonic guided ropivacaine or levobupivacaine transversus abdominis plane block had good analgesic effect in the high ligation of children's hernia sac.The analgesic effect of levobupivacaine was stronger than that of ropivacaine,both are equally safe.

关 键 词：疝囊高位结扎术 腹横肌平面阻滞 甲磺酸罗哌卡因 左旋布比卡因 镇痛效果 

分 类 号：R726.1[医药卫生—儿科]