氢吗啡酮复合罗哌卡因椎旁神经阻滞在胸腔镜手术中的应用效果
Application effect of hydromorphone combined with ropivacaine paravertebral nerve block in thoracoscopic surgery
杨静 1路敏 1孙婧婧 1张琳 1左明明1
作者信息
- 1. 沧州市人民医院麻醉科,河北 沧州,061000
- 折叠
摘要
目的:探讨氢吗啡酮复合罗哌卡因椎旁神经阻滞在胸腔镜手术中的应用效果.方法:将2021 年3 月至2023 年3 月行胸腔镜手术的90 例患者随机分为对照组与研究组,每组 45 例.对照组予以罗哌卡因行椎旁神经阻滞麻醉,研究组在对照组的基础上予以氢吗啡酮注射液,比较两组麻醉效果及患者血流动力学变化情况.结果:研究组与对照组术后 6h疼痛视觉模拟评分[(1.43±0.23)分vs.(2.58±0.51)分,P<0.05]、12h疼痛评分[(2.15±0.29)分vs.(3.34±0.63)分,P<0.05]、麻醉诱导后平均动脉压[(77.68±8.30)mmHg vs.(72.31±8.11)mmHg,P<0.05]、手术结束时平均动脉压[(85.25±8.82)mm-Hg vs.(80.99±8.36)mmHg,P<0.05]、麻醉诱导后心率[(67.08±7.02)次/min vs.(62.15±6.82)次/min,P<0.05]、手术结束时心率[(73.62±7.83)次/min vs.(67.34±7.04)次/min,P<0.05]、椎旁神经阻滞镇痛持续时间[(1 272.76±166.82)min vs.(654.02±82.13)min,P<0.05]、自控镇痛泵按压次数[(2.66±0.85)次 vs.(5.22±1.16)次,P<0.05]、术后48h氢吗啡酮用量[(5.26±1.02)mg vs.(6.46±1.38)mg,P<0.05]、不良反应中呕吐发生率(4.44%vs.22.22%,P<0.05)差异均有统计学意义.结论:氢吗啡酮复合罗哌卡因椎旁神经阻滞在胸腔镜手术中具有较好的镇痛效果,能显著减轻患者术后疼痛,维持术中血流动力学稳定,延长神经阻滞时间.
Abstract
Objective:To investigate the application effect of hydromorphone combined with ropivacaine paravertebral nerve block in thoracoscopic surgery.Methods:A total of 90 patients who underwent thoracoscopic surgery from Mar.2021 to Mar.2023 were randomly divided into control group and study group,with 45 cases in each group.Control group received ropivacaine for paravertebral nerve block anesthesia,while study group received hydromorphone injection based on control group.The anesthesia effects and hemody-namic changes of the two groups were compared.Results:There were significant differences between the study group and the control group in pain visual analogue score at 6 h after surgery[(1.43±0.23)points vs.(2.58±0.51)points,P<0.05]and 12 h after surgery[(2.15±0.29)points vs.(3.34±0.63)points,P<0.05],mean arterial pressure after anesthesia induction[(77.68±8.30)mmHg vs.(72.31±8.11)mmHg,P<0.05]and at the end of surgery[(85.25±8.82)mmHg vs.(80.99±8.36)mmHg,P<0.05],heart rate after anesthesia induction[(67.08±7.02)beats/min vs.(62.15±6.82)beats/min,P<0.05]and at the end of surgery[(73.62±7.83)beats/min vs.(67.34±7.04)beats/min,P<0.05],the duration of paravertebral nerve block analgesia[(1 272.76±166.82)min vs.(654.02±82.13)min,P<0.05],the compression times of patient controlled intravenous analgesia[(2.66±0.85)vs.(5.22±1.16),P<0.05],the postoperative48 h dosage of hydromorphone[(5.26±1.02)mg vs.(6.46±1.38)mg,P<0.05],the incidence of vomiting in adverse reactions(4.44%vs.22.22%,P<0.05).Conclusions:Hydromorphone combined with ropivacaine paravertebral nerve block has good analgesic effect in thoracoscopic surgery,which can obviously reduce postoperative pain,maintain intraoperative hemodynamic stability,and prolong nerve block time.
关键词
氢吗啡酮/罗哌卡因/椎旁神经阻滞/胸腔镜检查Key words
Hydromorphone/Ropivacaine/Paravertebral nerve block/Thoracoscopy引用本文复制引用
基金项目
沧州市重点研发指导计划项目(213106066)
出版年
2024
国家科技期刊平台
NSTL
万方数据