罗哌卡因与氟比洛芬酯用于淋巴静脉吻合术后镇痛效果的比较

发布时间：2018-03-24 10:51

本文选题：淋巴静脉吻合术　切入点：氟比洛芬酯　出处：《中国微创外科杂志》2017年03期

【摘要】：目的探讨罗哌卡因和氟比洛芬酯用于继发性上肢淋巴水肿患者淋巴静脉吻合术后的镇痛效果。方法2014年10月~2016年3月,选择全麻淋巴静脉吻合术45例,随机分为罗哌卡因组(R组)、氟比洛芬酯预处理组(F_1组)和氟比洛芬酯后处理组(F_2组)各15例。R组在手术结束时应用0.2%罗哌卡因10 ml局部浸润麻醉切口,F_1组于麻醉诱导前5 min静注氟比洛芬酯100 mg,F_2组于手术结束前5 min静注氟比洛芬酯100 mg。记录术后1、2、6、12、24和48 h的疼痛视觉模拟评分(visual analogue scale,VAS)和追加镇痛药的例数。结果术后2 h时R组静息痛和运动痛VAS均低于F_1组、F_2组[静息痛(3.4±0.7)分vs.(4.2±0.9)分vs.(4.1±1.0)分,F=3.741,P=0.032;运动痛(3.7±0.6)分vs.(4.6±0.9)分vs.(4.4±1.0)分,F=4.305,P=0.020];术后6 h时R组静息痛VAS低于F_1组、F_2组[(2.7±0.5)分vs.(3.4±0.5)分vs.(3.1±0.6)分,F=5.783,P=0.006]。术后2 h时R组需要使用镇痛药的患者例数少于F_1和F_2组(1例vs.7例vs.5例,χ~2=6.058,P=0.048)。结论淋巴静脉吻合术后罗哌卡因局部浸润麻醉能取得较好的术后镇痛效果。
[Abstract]:Objective to investigate the analgesic effect of ropivacaine and flurbiprofen in patients with secondary upper limb lymphedema. Methods from October 2014 to March 2016, 45 patients with lymphovenous anastomosis under general anesthesia were selected. They were randomly divided into ropivacaine group (n = 15), flurbiprofen preconditioning group (n = 15), flurbiprofen group (n = 15) and flurbiprofen post-treatment group (n = 15). Group R (n = 15) received 0.2% ropivacaine 10 ml local invasive anesthesia at the end of operation. 5 min before induction, flurbiprofen ester 100mg / F stack was injected intravenously 5 min before operation in group 2. Visual analogue scores (visual analogue scaleVASs) and additional analgesics were recorded at 1: 2 and 48 h after operation. Results at 2 h after operation, R. The VAS of rest pain and exercise pain in group F1 was lower than that in group F1 (3.4 卤0.7 vs.(4.2 卤0.9) vs.(4.1 卤1.0); in group R (3.7 卤0.6) vs.(4.6 卤0.9 vs.(4.6 卤1.0) vs.(4.4 卤1.0; VAS in group R was lower than that in group F1 at 6 h after operation [2.7 卤0.5 vs.(3.4 卤0.5 vs.(3.1 卤0.6]. The number of patients treated with analgesics was less than that in group F _ 1 and F _ 2 with vs.5 (蠂 ~ 2 6.058). Conclusion ropivacaine local infiltration anesthesia after lymphatic vein anastomosis can obtain better postoperative analgesic effect.
【作者单位】：首都医科大学附属世纪坛医院麻醉科;
【分类号】：R614.2

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