罗哌卡因局部和腹腔内联合浸润麻醉对LC术后的镇痛效果与不良反应分析  

Analysis of analgesic effects and adverse reactions of combined local and intraperitoneal infiltration anesthesia with ropivacaine after LC surgery

作　　者：应莎 YING Sha(Anesthesiology Department,Luxi County People's Hospital,Pingxiang 337200,China)

机构地区：[1]芦溪县人民医院麻醉科,337200

出　　处：《中国现代药物应用》2024年第7期117-120,共4页Chinese Journal of Modern Drug Application

基　　金：萍乡市科技计划项目(项目编号:2021PY247)。

摘　　要：目的分析罗哌卡因局部和腹腔内联合浸润麻醉对腹腔镜胆囊切除术(LC)术后的镇痛效果与不良反应发生情况。方法选择接受全身麻醉(全麻)下开展LC的患者60例,按随机数字表法分成观察组与对照组,各30例。对照组手术完毕不接受镇痛药物以及其他阵痛和方式的干预,观察组运用罗哌卡因局部和腹腔内联合浸润麻醉。比较两组术后各时间段的视觉模拟评分法(VAS)评分、需额外使用双氯芬酸钠栓情况、肛门通气时间、下床活动时间、24 h内术后恶心呕吐(PONV)评分。结果观察组在术后0、2、4、8、12、24h的VAS评分均比对照组要低,且呈现出差异表现(P<0.05)。观察组需额外使用双氯芬酸钠栓的患者占比13.3%低于对照组的40.0%,数据对比呈现出差异表现(P<0.05)。两组肛门通气时间比较未呈现出差异表现(P>0.05);观察组患者术后下床活动时间(1.23±0.42)d早于对照组的(2.10±0.79)d,数据对比呈现出差异表现(P<0.05)。观察组PONV评分(0.77±0.76)分低于对照组的(1.37±0.79)分,数据对比呈现出差异表现(P<0.05)。结论罗哌卡因局部和腹腔内联合浸润麻醉的应用能够降低LC患者术后的疼痛,需额外镇痛的情况较少,且不良反应较轻,因此,这种麻醉方式值得借鉴。Objective To analyze the analgesic effects and adverse reactions of combined local and intraperitoneal infiltration anesthesia with ropivacaine after laparoscopic cholecystectomy(LC)surgery.Methods A total of 60 patients undergoing LC under general anesthesia were selected and divided into an observation group and a control group according to random number table method,with 30 patients in each group.The control group did not receive analgesic drugs or other labor intervention after the operation,and the observation group received local and intraperitoneal infiltration anesthesia.The visual analogue scale(VAS)score,requiring additional diclofenac sodium suppositories,anal ventilation time,off-bed ambulation time,postoperative nausea and vomiting(PONV)score within 24 h were compared between the two groups.Results VAS scores of the observation group at 0,2,4,8,12 and 24 h after the operation were lower than those of the control group,and the data comparison showed a difference(P<0.05).The proportion of patients requiring additional diclofenac sodium suppositories in the experimental group was 13.3%,which was lower than 40.0%in the control group,and the data comparison showed a difference(P<0.05).There was no difference in anal ventilation time between the two groups(P>0.05).The postoperative off-bed ambulation time in the observation group was(1.23±0.42)d,which was earlier than(2.10±0.79)d in the control group,and the data comparison showed a difference(P<0.05).The PONV score of the observation group was(0.77±0.76)points,which was lower than(1.37±0.79)points of the control group,and the data comparison showed a difference(P<0.05).Conclusion The application of combined local and intraperitoneal infiltration anesthesia with ropivacaine can reduce postoperative pain in patients undergoing LC surgery,with less need for additional analgesia and mild adverse reactions.Therefore,this anesthesia method is worth learning.

关 键 词：罗哌卡因 局部麻醉 腹腔内麻醉 浸润麻醉 腹腔镜胆囊切除术 术后镇痛 不良反应 

分 类 号：R614[医药卫生—麻醉学]