罗哌卡因局部浸润麻醉对腰椎间盘切除术后切口疼痛的影响分析

发布时间：2018-12-14 00:57

【摘要】：目的研究罗哌卡因的局部浸润麻醉对腰椎间盘切除术后患者切口疼痛的影响。方法选择在我院接受全麻性腰椎间盘切除术患者120例作为研究对象,并根据患者麻醉方式的不同将其分为三组,每组各含患者40例。A组患者在实施麻醉后、切皮前应用肾上腺素和0.25%的罗哌卡因逐层浸润切口皮下、肌层等;B组患者在实施麻醉后、切皮前,应用肾上腺素和0.9%的生理盐水逐层浸润切口皮下、肌层等;C组患者不实施局部浸润麻醉处理。对三组患者手术后2h、4h、6h、8h以及12h安静时患者的疼痛视觉模拟评分进行详细记录,同时记录手术后12h、24h额外镇痛药的人数、患者的伤口愈合情况以及患者睡眠质量情况。结果 A组患者手术后6h、8h、12h的疼痛视觉模拟评分明显低于其他两组,(P0.05)差异有统计学意义;A组患者手术后12h、24h要求给予额外镇痛药的人数明显低于B组与C组,睡眠质量明显优于B组与C组,(P0.05),差异存在统计学意义。三组患者在手术时间、手术后的拆线时间无明显差异,均未有伤口感染患者(P0.05)。结论罗哌卡因局部浸润麻醉用于腰间盘切除术中,能够有效的提升镇痛效果,保障患者睡眠质量,减少患者额外镇痛药的使用量,临床应用价值显著。
[Abstract]:Objective to study the effect of ropivacaine local infiltration anesthesia on incision pain after lumbar discectomy. Methods 120 patients undergoing general anesthesia discectomy in our hospital were selected and divided into three groups according to different anesthetic methods, each group consisted of 40 patients. Before skin incision, epinephrine and 0.25% ropivacaine were used to infiltrate subcutaneously and muscularly. The patients in group B were treated with epinephrine and 0.9% of normal saline to infiltrate subcutaneously and muscularly respectively before skin incision, while patients in group C were not treated with local infiltration anesthesia. The visual analogue scores of pain were recorded at 2 h, 4 h, 6 h, 8 h and 12 h after operation, and the number of additional painkillers at 12 h and 24 h after operation were recorded. Wound healing and sleep quality. Results the visual analogue score of pain in group A was significantly lower than that in the other two groups (P 0.05). The number of patients in group A who required extra analgesic at 12 hours after operation was significantly lower than that in group B and group C, and the sleep quality was significantly better than that in group B and group C (P0.05). There was no significant difference between the three groups in the time of operation and the time of removing thread after operation. There was no wound infection in all patients (P0.05). Conclusion Local invasive ropivacaine anesthesia for lumbar discectomy can effectively improve the analgesic effect, ensure the sleep quality of patients, reduce the use of additional analgesic drugs, and the clinical application value is significant.
【作者单位】：中国人民解放军第92医院麻醉科;
【分类号】：R614

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