食管癌根治术连续硬膜外麻醉复合全身麻醉中罗哌卡因最适浓度的临床研究  

Optimal concentration of ropivacaine in continuous epidural anesthesia combined with general anesthesia for radical resection of esophageal cancer

作　　者：王宏志[1] 李峰[2] Wang Hongzhi;Li Feng(Department of Anesthesiology,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Research,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院麻醉科,太原030013 [2]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院科研科,太原030013

出　　处：《肿瘤研究与临床》2024年第7期515-518,共4页Cancer Research and Clinic

基　　金：山西省卫生健康委员会科研课题(2023015)。

摘　　要：目的探讨食管癌根治术连续硬膜外麻醉复合全身麻醉中罗哌卡因的最适浓度。方法回顾性病例系列研究。收集2020年2月至2022年2月山西省肿瘤医院100例接受食管癌根治术患者的临床资料,依据连续硬膜外麻醉复合全身麻醉中使用罗哌卡因的浓度将患者分为0.25%浓度组和0.50%浓度组,各50例。比较两组患者进入手术室时(T_(0))、全身麻醉诱导后5 min(T_(1))、拔管时(T_(2))生命体征、镇痛效果、麻醉苏醒时间、麻醉满意度。结果两组患者年龄、性别、体质量比较,差异均无统计学意义(均P>0.05)。两组T_(1)的心率、平均动脉压(MAP)均低于T_(0)、T_(2)(均P<0.05),但T_(0)与T_(2)的心率、MAP分别比较,差异均无统计学意义(均P>0.05);T_(0)、T_(1)、T_(2)两组间的心率、MAP分别比较差异均无统计学意义(均P>0.05)。0.25%浓度组静态视觉模拟评分法(VAS)评分低于0.50%浓度组[(1.24±0.28)分比(2.58±0.41)分,t=19.09,P<0.05],动态VAS评分亦低于0.50%浓度组[(2.86±0.47)分比(4.02±1.16)分,t=6.55,P<0.05]。0.25%浓度组自主呼吸恢复时间、拔管时间、完全清醒时间均短于0.50%浓度组,差异均有统计学意义(均P<0.05)。0.25%浓度组麻醉满意率高于0.50%浓度组[94%(47/50)比78%(39/50),χ^(2)=5.32,P<0.05]。结论食管癌根治术连续硬膜外麻醉复合全身麻醉中罗哌卡因的最适浓度为0.25%。Objective To investigate the optimal concentration of ropivacaine in continuous epidural anesthesia combined with general anesthesia for radical resection of esophageal cancer.Methods A retrospective case series study was conducted.A total of 100 patients with esophageal cancer undergoing radical surgery in Shanxi Province Cancer Hospital from February 2020 to February 2022 were collected.According to the concentration of ropivacaine in continuous epidural anesthesia combined with general anesthesia,all patients with esophageal cancer were divided into 0.25%concentration group and 0.50%concentration group,50 cases in each group.The vital signs,analgesic effects,time of recovery from anesthesia and satisfaction with anesthesia of the 2 groups at entering the operating room(T_(0)),5 minutes after general anesthesia induction(T_(1)),and time of extubation(T_(2))were compared.Results There were statistically significant differences in the age,gender,body mass of the both groups(all P>0.05).The heart rate,mean arterial pressure(MAP)at T_(1)were lower than those at T_(0)and T_(2)(all P<0.05),but there were no significant differences in heart rate and MAP at T_(0)and T_(2)(all P>0.05);at T_(0),T_(1)and T_(2),there were no significant differences in HR and MAP between the both groups(all P>0.05).The static visual analogue scale(VAS)score of patients in the 0.25%concentration group was lower than that in the 0.50%concentration group[(1.24±0.28)scores vs.(2.58±0.41)scores,t=19.09,P<0.05],and the dynamic VAS score in the 0.25%concentration group was lower than that in the 0.50%concentration group[(2.86±0.47)scores vs.(4.02±1.16)scores,t=6.55,P<0.05].The recovery time of spontaneous respiration,the extubation time and the time of complete consciousness in the 0.25%concentration group was shorter than those in the 0.50%concentration group(all P<0.05).The anesthesia satisfaction in the 0.25%concentration group was higher than that in the 0.50%concentration group[94%(47/50)vs.78%(39/50),χ^(2)=5.32,P<0.05].Conclusions The o

关 键 词：食管肿瘤 麻醉 全身 麻醉 硬膜外 罗哌卡因 最适浓度 

分 类 号：R735.1[医药卫生—肿瘤] R614[医药卫生—临床医学]