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  

Application of Ropivacaine Mesylate and Levobupivacaine in Ultrasound-guided Plane Block of Transverse Abdominal Muscle During High Ligation of Hernia Sac

作　　者：刘学师 李娜[1] 王红平 LIU Xueshi;LI Na;WANG Hongping(Department of Anesthesiology and Surgery,Gansu Maternal and Child Health Hospital,Lanzhou,Gansu Province,730050 China)

机构地区：[1]甘肃省妇幼保健院麻醉手术科,甘肃兰州730050

出　　处：《世界复合医学》2023年第9期195-198,共4页World Journal of Complex Medicine

摘　　要：目的探讨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效果。方法回顾性分析2022年4月—2023年4月甘肃省妇幼保健院85例疝囊高位结扎术患儿的临床资料,根据不同麻醉用药方案将进行分组,对照组42例患儿给予左旋布比卡因超声引导腹横肌平面阻滞,研究组43例患儿给予甲磺酸罗哌卡因超声引导腹横肌平面阻滞。对比两组患儿血流动力学指标、麻醉恢复相关指标、瑞芬太尼用量与住院时间、镇痛效果及不良反应发生率。结果两组患儿在麻醉诱导前、插入喉罩后、手术开始时及移除喉罩时的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)水平比较,差异无统计学意义(P>0.05)。两组患儿恢复自主呼吸时间、苏醒时间、定向力恢复时间、拔管时间、麻醉恢复室停留时间比较,差异无统计学意义(P>0.05);研究组患儿瑞芬太尼用量较对照组高,差异有统计学意义(P<0.05),两组住院时间相比,差异无统计学意义(P>0.05);术后即刻及术后24 h时两组患儿儿童疼痛行为量表(The Face,Legs,Activity,Cry,Consolability Behavioral Tool,FLACC)评分相比,差异无统计学意义(P>0.05),研究组术后4 h及12 h时FLACC评分(1.71±0.29)分、(1.45±0.35)分较对照组(1.58±0.23)分、(1.18±0.39分)高,差异有统计学意义(t=2.286、3.361,P<0.05)。结论在疝囊高位结扎术超声引导腹横肌平面阻滞麻醉中甲磺酸罗哌卡因与左旋布比卡因的镇痛效果和安全性都比较明显,但是后者镇痛效果更优。Objective To explore the application effect of ropivacaine mesylate and levobupivacaine in ultrasound-guided plane block of transverse abdominal muscle during high ligation of hernia sac.Methods Retrospective analysis of clinical data of 85 children undergoing high ligation of hernia sac in Gansu Maternal and Child Health Hospital from April 2022 to April 2023.Groups will be grouped according to different anesthetic protocol,42 children in the control group received levobupivacaine ultrasound-guided transverse abdominis plane block,and 43 children in the study group received ropivacaine mesylate ultrasound-guided transverse abdominis plane block.Comparison of hemodynamic indicators,anesthesia recovery related indicators,remifentanil dosage and hospital stay,analgesic effect,and incidence of adverse reactions between two groups of pediatric patients.Results There was no statistically significant difference in the mean arterial pressure(MAP)and heart rate(HR)levels between the two groups of children before anesthesia induction,after insertion of the laryngeal mask,at the beginning of surgery,and after removal of the laryngeal mask(P>0.05).There was no statistically significant difference in the recovery time of spontaneous breathing,awakening time,directional force recovery time,extubation time,and anesthesia recovery room stay time between the two groups of children(P>0.05);The dosage of remifentanil in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in hospital stay between the two groups(P>0.05);There was no statistically significant difference in the scores of the Face,Legs,Activity,Cry,Consolability Behavior Tool(FLACC)between the two groups of children immediately after surgery and 24 hours after surgery(P>0.05).The FLACC scores of the study group(1.71±0.29)points and(1.45±0.35)points were higher than those of the control group(1.58±0.23)points and(1.18±0.39)points at 4 and 12 hours

关 键 词：甲磺酸罗哌卡因 左旋布比卡因 疝囊高位结扎术 镇痛效果 

分 类 号：R726.1[医药卫生—儿科]