摘要
目的探讨腹腔镜子宫切除术应用地佐辛联合罗哌卡因超前镇痛的镇痛效果。方法怀来县中医院于2011年6月至2012年1月择期行腹腔镜子宫切除术患者(美国麻醉医师协会分级Ⅰ、Ⅱ级)96例,采用区组随机化分组法分成超前镇痛组和术后镇痛组,各48例。超前镇痛组于手术结束前30 min子宫切除后残端缝合时静脉滴注地佐辛0.1 mg/kg;并于切皮前在每个切口周围用0.5%罗哌卡因3 mL进行阻滞、术毕拔套管时盆腔喷洒0.25%罗哌卡因15 mL;术后镇痛组在手术结束后、自主呼吸恢复、拔除气管插管后单纯给予静脉滴注地佐辛0.1 mg/kg。术后30 min、2 h、6 h、12 h、24 h对患者术后的疼痛程度采用视觉模拟评分法(VAS)进行评分并记录术后止痛药的需求情况及术后不良反应情况。结果超前镇痛组术后30 min、2 h、6 h、12 h、24 h VAS评分明显低于术后镇痛组。超前镇痛组没有患者术后需要止痛药,术后镇痛组却有9例。两组恶心、呕吐发生率比较差异无统计学意义。结论地佐辛联合罗哌卡因术前应用在腹腔镜子宫切除术中能起到超前镇痛作用,可安全、有效地减轻术后疼痛。
Objective To probe into the analgesia effect of application of dezocine combined with ropiv- acaine on laparoscopic hysterectomy. Methods Ninety-six cases undergoing laparoseopic hysterectomy （ grade I , II by ASA ） from Huailai County Chinese Medicine Hospital from Jun. 2011 to Jan. 2012, were ran- domly divided into preemptive analgesia and postoperative analgesia groups with 48 cases in each group. Pre- emptive analgesia group was given an intravenous injection of dezocine 0.1 mg/kg 30 minutes before the op- eration was over when sewing the hysterectomy residual; before skin incision ,0.5% ropivaeaine was given 3 mL for incision block; and 0.25% ropivaeaine 15 mL was sprayed to the pelvic at the end of the surgery. While the postoperative analgesia group was given an intravenous injection of dezoeine 0.1 mg/kg in the con- dition of awake, spontaneously breathing recovery and tracheal extubation. After 30 min,2,6,12,24 hour, the postoperative analgesic requirements and postoperative adverse reaction were recorded and postoperative pain of patients using Visual Analogue Score （VAS） was scored. Results After 30 min, 2,6,12,24 hours, the VAS score of the preemptive analgesia group was significantly lower than postoperative analgesia group. No patients in the preemptive analgesia group required postoperative pain killer,but 9 patients in the postopera- tive analgesia group needed it. Nausea and vomiting of the two groups had no statistically significant differ- ence. Conclusion Dezocine combined with ropivacaine preoperative application in laparoseopie hysterectomy ~ ~Rn nlav nr^motive analeesic effect, which can relieve postoperative pain sately and ettectlvely.
出处
《医学综述》
2013年第11期2094-2096,共3页
Medical Recapitulate
