摘要
目的评估罗哌卡因持续切口浸润麻醉对开腹胃癌根治术后的镇痛效果及对早期康复的影响。方法回顾性分析2011年6月至2014年10月期间榆林市第二医院普通外科开腹行胃癌根治术的50例患者的临床资料,根据镇痛方法不同分为罗哌卡因持续切口浸润麻醉组(简称"罗哌卡因组")和生理盐水对照组(简称"对照组"),每组均为25例。所有患者均使用静脉自控麻醉泵,比较不同时间点(术后4 h、8 h、16 h、24 h、48 h)视觉模拟评分法(VAS)评分、舒适度(BCS)评分、术后恶心呕吐评分,以及2组间累计静脉自控镇痛药物使用量、首次下床活动时间、肠功能恢复时间、住院时间、切口感染发生情况。结果罗哌卡因组在术后4 h、8 h、16 h、24 h、48 h时的VAS评分均明显低于对照组(P<0.05)、BCS评分均明显高于对照组(P<0.05)。罗哌卡因组48 h时舒芬太尼用药量明显少于对照组(P<0.05)。与对照组相比,罗哌卡因组患者肠功能恢复时间、首次下床活动时间、术后住院时间均明显缩短(P<0.05),恶心呕吐评分明显降低(P<0.05)。2组切口感染发生率比较,差异无统计学意义(P>0.05)。结论罗哌卡因持续切口浸润麻醉用于开腹胃癌根治术后镇痛安全、有效,能够促进患者早期康复。
Objective To assess postoperative analgesia and early rehabilitation of continuous incision infiltration with ropivacaine in open gastrectomy.Methods From June 2011 to October 2014,50 patients underwent open gastrectomy were divided into two groups：standard analgesic therapy group（Abbreviation：standard group,n=25） and continuous incision infiltration with ropivacaine group（Abbreviation：ropivacaine group,n=25）.All the patients were also given patient controlled intravenous analgesia（PCIA）.Points of visual analog scale（VAS）,Bruggrmann comfort scale（BCS）,and nausea and vomiting were assessed at different time during the first 48 hours postoperatively.Total sufentanil dosage,the first postoperative ambulation time,bowel recovery time,postoperative hospital stay,and incision infection rate were compared between two groups.Results At 4 h,8 h,16 h,24 h,48 h postoperatively,the points of VAS in the ropivacaine group were significantly lower than those in the standard group（P〈0.05）,the points of BCS in the ropivacaine group were significantly higher than those in the standard group（P〈0.05）.Compared with the standard group,the dosage of sufentanil was significantly less（P〈0.05）,the bowel recovery time,the first postoperative ambulation time,and the postoperative hospital stay were significantly shorter（P〈0.05）,the point of nausea and vomiting was significantly lower（P〈0.05） at 48 h postoperatively in the ropivacaine group.There was no difference of the incision infection rate between the two groups（P〉0.05）.Conclusion Continuous incision infiltration with ropivacaine is effective and safe to relief postoperative pain and accelerate patient＇s recovery after open gastrectomy.
出处
《中国普外基础与临床杂志》
CAS
2015年第11期1359-1362,共4页
Chinese Journal of Bases and Clinics In General Surgery
