ERAS理念下妇科领域不同浓度的罗哌卡因腰方肌阻滞多模式镇痛的临床研究
Clinical study on multimode analgesia of different concentrations of ropivacaine in gynecological field under the concept of ERAS
李敏 1黄贻勇 2李婧 1马军1
作者信息
- 1. 乌鲁木齐市友谊医院,乌鲁木齐 830046
- 2. 新疆乌鲁木齐市中医院,乌鲁木齐 830099
- 折叠
摘要
目的 分析ERAS理念下,不同浓度罗哌卡因在妇科术后腰方肌外侧入路阻滞中的应用,探索多模式术后镇痛及快速康复的用药浓度.方法 选取择期全身麻醉下进行的妇科手术患者96例,根据双侧腰方肌外侧入路阻滞中罗哌卡因药物浓度的不同,按随机数字表法分为Q1组(罗哌卡因浓度为0.25%)、Q2组(罗哌卡因浓度为0.33%)、Q3组(罗哌卡因浓度为0.50%)三组,每组32例,记录三组患者术后2 h、6 h、12 h、24 h、48 h的VAS评分,观察并比较三组患者术后首次下床时间、住院时间、不良反应发生率.结果 Q2组、Q3组VAS评分均低于Q1组,结果比较差异有统计学意义(P<0.05).Q2、Q3组VAS评分比较(P＞0.05).Q2组、Q3组的罗哌卡因浓度均具有较好的镇痛效果.Q1、Q2组不良反应发生率低于、Q3组结果比较差异有统计学意义(P<0.05),Q1组、Q2组不良反应发生率比较(P＞0.05).Q2组和Q1组罗哌卡因浓度发生不良反应率较低.三组均无严重并发症及不良事件发生.结论 双侧腰方肌侧路入路给予0.33%的罗哌卡因20 ml在妇科术后的多模式镇痛,可有效降低疼痛评分、减少术后首次下床时间及住院时间、不增加不良反应的发生,是安全可靠且效果满意的用药浓度.
Abstract
Objective To analyze the application of different concentrations of ropivacaine in lateral quadrat lumbotomy postoper-ative block under the concept of ERAS,and to explore the drug concentration of multi-mode postoperative analgesia and rapid rehabili-tation.Methods 96 patients undergoing gynecological surgery under elective general anesthesia were randomly divided into group Q1(ropivacaine concentration 0.25%),group Q2(ropivacaine concentration 0.33%)and group Q3(ropivacaine concentration 0.50%)ac-cording to the different concentrations of ropivacaine in bilateral quadratus lumbosi lateral approach block.The VAS scores of the three groups were recorded at 2 h,6 h,12 h,24 h and 48 h after operation,and the first time of getting out of bed,hospital stay and the inci-dence of adverse reactions were observed and compared among three groups.Results VAS scores of group Q2 and Q3 were lower than those of group Q1,and the difference was statistically significant(P<0.05).VAS scores between Q2 and Q3 groups were similiar(P＞0.05).The concentration of ropivacaine in group Q2 and group Q3 had better analgesic effect.The incidence of adverse reactions in Q1 and Q2 groups was lower than that in Q3 group(P<0.05),and the incidence of adverse reactions in Q1 and Q2 groups was low-er than that in Q3 group(P＞0.05).The adverse reaction rate of ropivacaine concentration in group Q2 and group Q1 was lower.No se-rious complications or adverse events occurred in three groups.Conclusion 0.33%ropivacaine 20ml administered by bilateral qua-dratus lumbois lateral approach can effectively reduce the pain score,reduce the first postoperative time of getting out of bed and hospi-tal stay,and do not increase the occurrence of adverse reactions,which is a safe,reliable and satisfactory drug concentration.
关键词
ERAS/妇科/腰方肌外侧入路阻滞/超声引导/多模式术后镇痛Key words
ERAS/Gynecology/Lateral quadrat lumbotomy postoperative block/Ultrasound guidance/Multimode postoperative analgesia引用本文复制引用
基金项目
乌鲁木齐市卫生健康委员会课题(201916)
出版年
2024
NETL
NSTL
万方数据