不同浓度罗哌卡因切口持续浸润用于乳腺癌患者术后镇痛的效果

发布时间：2018-02-26 02:23

本文关键词： 罗哌卡因术后镇痛乳腺癌根治术　出处：《临床麻醉学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的观察罗哌卡因切口持续浸润用于乳腺癌患者术后镇痛的有效浓度。方法择期行乳腺癌根治术患者100例,年龄40~70岁,ASAⅠ或Ⅱ级,按照随机数字表法分为四组:0.2%(R1组)、0.3%(R2组)、0.4%(R3组)罗哌卡因切口持续浸润组和地佐辛复合曲马多患者静脉自控镇痛组(PCIA组),每组25例。记录患者术后2h(T1)、4h(T2)、8h(T3)、12h(T4)、24h(T5)、48h(T6)时安静和90°翻身活动时的VAS疼痛评分、Ramsay镇静评分及恶心、呕吐、头晕、呼吸抑制等不良反应发生情况。结果 T1~T6时R1组安静和90°翻身活动时VAS评分明显高于PCIA组(P0.05),R2和R3组VAS评分与PCIA组差异无统计学意义。R1、R2和R3组Ramsay镇静评分均明显低于PCIA组(P0.05),三组间差异无统计学意义。PCIA组出现2例恶心呕吐,其余各组均未发生恶心呕吐等不良反应。结论 0.3%罗哌卡因切口持续浸润对乳腺癌根治术后镇痛安全有效。
[Abstract]:Objective to observe the effective concentration of postoperative analgesia with continuous ropivacaine incision in breast cancer patients. According to the method of random number table, four groups were divided into four groups: 0. 3% 0. 2% and 0. 3% R 2 group.) ropivacaine incision continuous infiltration group and dizoxin combined with tramadol patient-controlled intravenous analgesia group (PCIA group, 25 cases, each group, 25 cases) were recorded at 2 hours after operation, 12 h, 12 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 24 h, 4 h, 24 h, 4 h, 24 h, 4 h, 4 h, 4 h, 4 h, 2 h after operation, 2 h after operation, and 90 掳turn over. VAS pain score, sedation score and nausea, Vomiting, dizziness, Results the VAS score at rest and 90 掳turnover in group R1 was significantly higher than that in group PCIA (P 0.05) and VAS score in group R3 was not significantly different from that in group PCIA. The scores of Ramsay sedation in group R1 and group R3 were significantly lower than those in group PCIA. There was no significant difference among the three groups in PCIA group. 2 cases of nausea and vomiting were found in PCIA group. Conclusion continuous infiltration of 0.3% ropivacaine incision is safe and effective for postoperative analgesia of breast cancer.
【作者单位】：徐州医科大学江苏省麻醉学重点实验室;临沂市人民医院麻醉科;解放军南京总医院麻醉科;解放军南京总医院普通外科;
【分类号】：R614;R737.9

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