倍他米松复合罗哌卡因局部浸润对腹腔镜胆囊切除术患者术后镇痛效果及睡眠深度的影响  

Effect of betamethasone combined with ropivacaine on postoperative analgesia and sleep depth in patients undergoing laparoscopic cholecystectomy

作　　者：于学来 万政佐[1] 李亚楠[1] Yu Xuelai;Wan Zhengzuo;Li Yanan(Department of Anesthesiology,Hangzhou Traditional Chinese Medicine Hospital,Hangzhou 310012,China)

机构地区：[1]杭州市中医院麻醉科,杭州310012

出　　处：《中国医师杂志》2024年第12期1862-1865,共4页Journal of Chinese Physician

基　　金：浙江省医师协会临床研究基金(2021YSXH01)。

摘　　要：目的观察倍他米松复合罗哌卡因局部浸润对腹腔镜胆囊切除术患者术后镇痛效果及睡眠深度的影响。方法选取杭州市中医院2021年10月至2022年12月收治的150例行腹腔镜胆囊切除术的患者为研究对象,采用随机数字表法将患者分为A组、B组、C组,每组50例。A组和B组采用罗哌卡因和不同剂量(5 mg、2.5 mg)倍他米松镇痛,C组仅采用罗哌卡因镇痛。比较三组围手术期指标;比较三组术后4、8、12、24、48 h疼痛程度及术前1 d、术后1 d和2 d匹兹堡睡眠指数(PSQI)评分。结果三组手术时间、麻醉时间、术后排气时间和住院时间及芬太尼、丙泊酚用量比较差异均无统计学意义(均P>0.05)。A组和B组术后4、8、12、24 h和48 h的VAS评分均明显低于C组(均P<0.05),且A组术后12、24 h和48 h的VAS评分均明显低于B组(均P<0.05)。三组术前1 d的PSQI评分比较差异均无统计学意义(均P>0.05);A组和B组术后1、2 d的PSQI评分均明显低于C组(均P<0.05),A组术后2 d的PSQI评分明显低于B组,差异有统计学意义(P<0.05)。A组和B组的不良反应发生率与C组差异无统计学意义(均P>0.05)。结论倍他米松复合罗哌卡因局部浸润对腹腔镜胆囊切除术患者的术后镇痛效果较佳,并改善患者睡眠质量。ObjectiveTo observe the effect of betamethasone combined with ropivacaine on postoperative analgesia and sleep depth in patients undergoing laparoscopic cholecystectomy.MethodsA total of 150 patients undergoing laparoscopic cholecystectomy treated in the Hangzhou Traditional Chinese Medicine Hospital from October 2021 to December 2022 were selected as the study objects and divided into group A,group B and group C,with 50 cases in each group.Groups A and B were treated with ropivacaine and betamethasone at different doses(5 mg,2.5 mg),while group C was treated with ropivacaine only.The perioperative period indexes of the three groups were compared.Pain degree at 4,8,12,24 and 48 h after surgery and Pittsburgh Sleep index(PSQI)scores at 1 day before surgery,1 day and 2 days after surgery were compared among the three groups.ResultsThere were no significant differences in operation time,anesthesia time,postoperative exhaust time and hospital stay,and the dosage of fentanyl and propofol among the three groups(all P>0.05).The Visual Analogue Scale(VAS)scores of group A and group B at 4,8,12,24 and 48 h after surgery were significantly lower than those of the group C(all P<0.05),and the VAS scores of group A at 12,24 and 48 h after surgery were significantly lower than those of the group B(all P<0.05).There was no significant difference in PSQI scores 1 day before surgery among the three groups(all P>0.05).The PSQI scores of the group A and the group B 1 and 2 days after surgery were significantly lower than those of the group C(all P<0.05),and the PSQI scores of the group A 2 days after surgery were significantly lower than those of the group B,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the group A and the group B and the group C(all P>0.05).ConclusionsBetamethasone combined with ropivacaine can improve postoperative analgesia and sleep quality in patients undergoing laparoscopic cholecystectomy.

关 键 词：倍他米松 罗哌卡因 胆囊切除术 腹腔镜 镇痛 睡眠 

分 类 号：R614[医药卫生—麻醉学]