腹腔镜胃癌根治术后应用不同剂量布比卡因竖脊肌平面阻滞的镇痛效果  被引量:1

Analgesic effect of different doses of bupivacaine erector spinae plane block after laparoscopic radical gastrectomy

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作  者:胡微澜[1] 韩威利 李明勇[1] HU Weilan;HAN Weili;LI Mingyong(Department of Anesthesiology and Perioperative Medicine,Xinxiang Central Hospital,Xinxiang,Henan 453000)

机构地区:[1]新乡市中心医院麻醉与围术期医学科,河南新乡453000

出  处:《郑州大学学报(医学版)》2024年第5期683-686,共4页Journal of Zhengzhou University(Medical Sciences)

基  金:河南省医学科技攻关计划项目(LHGJ20210919)。

摘  要:目的:比较腹腔镜胃癌根治术后应用不同剂量布比卡因竖脊肌平面阻滞(ESPB)的镇痛效果。方法:选取2019年12月至2022年12月于新乡市中心医院行ESPB腹腔镜胃癌根治术的患者,其中45例(研究1组)采用30 mL 0.25%(质量分数)布比卡因,与研究1组性别、年龄、分期等资料匹配的45例(研究2组)采用20 mL 0.25%布比卡因。记录两组ESPB后2(T1)、4(T2)、8(T3)、12(T4)、24(T5)、48(T6)h时疼痛视觉模拟评分(VAS),术后24 h曲马多使用率、镇痛泵按压次数和术后24 h镇痛满意度,术后不良反应发生情况。结果:静息和咳嗽状态下两组患者VAS评分均随时间延长先升高后降低;研究1组静息状态下T2~T6、咳嗽状态下T1~T6的VAS评分均低于研究2组(P<0.05)。研究1组术后镇痛满意度评分高于研究2组(P<0.05),曲马多使用率、镇痛泵按压次数低于研究2组(P<0.05)。研究1组和2组恶心呕吐、眩晕、胸闷、瘙痒等总不良反应发生率分别为31.1%和35.6%,差异无统计学意义(P>0.05)。结论:腹腔镜胃癌根治术后30 mL 0.25%布比卡因ESPB的镇痛效果更为理想。Aim:To compare the analgesic effect of erector spinal muscle plane block(ESPB)using different doses of bupivacaine after laparoscopic radical gastrectomy.Methods:A total of 45 patients(group 1)who underwent laparoscopic radical gastrectomy with 30 mL 0.25%(mass percent)bupivacaine ESPB in Xinxiang Central Hospital from December 2019 to December 2022 were selected.According to gender,age,tumor stage and other data,45 patients(group 2)who received 20 mL 0.25%bupivacaine ESPB after laparoscopic radical gastrectomy were matched.Pain visual analogue scale(VAS)at 2 hour(T1),4 hour(T2),8 hour(T3),12 hour(T4),24 hour(T5)and 48 hour(T6)after ESPB was performed,the usage rate of tramadol,the number of analgesic pump compression,and analgesic satisfaction score within 24 hours after operation were recorded;the adverse reactions were observed.Results:In the coughing state and resting state,VAS scores of the 2 groups increased firstly and then decreased with time(P<0.05).VAS scores at T1-T6 in the coughing state and T2-T6 in the resting state of group 1 were lower than those of group 2(P<0.05).The analgesic satisfaction score of group 1 was higher than that of group 2,while the usage rate of tramadol and the number of analgesic pump compression were lower(P<0.05).The total occurence of nausea and vomiting,vertigo,chest tightness and pruritus in group 1 and group 2 was 31.1%and 35.6%,respectively,and there was no significant difference between the 2 groups(P>0.05).Conclusion:The analgesic effect of 30 mL 0.25%bupivacaine ESPB after laparoscopic radical gastrectomy is more ideal.

关 键 词:竖脊肌平面阻滞 胃癌根治术 腹腔镜手术 布比卡因 术后镇痛 

分 类 号:R614[医药卫生—麻醉学]

 

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