CAJ | 학술논문

目的观察在手术结束前应用罗哌卡因局部浸润对脊髓损伤患者术后镇痛的影响.方法60例美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级拟在静吸复合全麻下行骨折切开复位内固定的脊髓损伤患者,分为3组:低浓度罗哌卡因浸润麻醉组(RL 组, n=20)在手术结束前应用0.25%罗哌卡因对手术切口进行局部浸润麻醉;中浓度罗哌卡因浸润麻醉组(RM 组,n=20)在手术结束前应用0.5%罗哌卡因对手术切口进行局部浸润麻醉;对照组(C 组,n=20)在手术结束前直接缝合切口,不给予任何局部麻醉药.观察患者术后2 h、6 h、24 h、48 h 的疼痛视觉模拟评分(VAS),观察麻醉恢复时间及手术结束后的躁动评分及相关副作用发生情况.结果 RL 组和 RM 组患者在全麻苏醒期及术后6 h 内的躁动评分低于 C 组(P<0.05),RL 组和 RM 组患者在术后2 h、6 h、24 h 的VAS 评分、平均动脉压及心率低于 C 组(P<0.05),恢复时间较 C 组显著缩短(P<0.001).3组间的副作用发生率无显著性差异(P>0.05).结论罗哌卡因局部浸润麻醉能够有效地降低脊髓损伤患者术后疼痛,减轻术后躁动.
목적관찰재수술결속전응용라고잡인국부침윤대척수손상환자술후진통적영향.방법60례미국마취의사협회(ASA)분급Ⅰ~Ⅱ급의재정흡복합전마하행골절절개복위내고정적척수손상환자,분위3조:저농도라고잡인침윤마취조(RL 조, n=20)재수술결속전응용0.25%라고잡인대수술절구진행국부침윤마취;중농도라고잡인침윤마취조(RM 조,n=20)재수술결속전응용0.5%라고잡인대수술절구진행국부침윤마취;대조조(C 조,n=20)재수술결속전직접봉합절구,불급여임하국부마취약.관찰환자술후2 h、6 h、24 h、48 h 적동통시각모의평분(VAS),관찰마취회복시간급수술결속후적조동평분급상관부작용발생정황.결과 RL 조화 RM 조환자재전마소성기급술후6 h 내적조동평분저우 C 조(P<0.05),RL 조화 RM 조환자재술후2 h、6 h、24 h 적VAS 평분、평균동맥압급심솔저우 C 조(P<0.05),회복시간교 C 조현저축단(P<0.001).3조간적부작용발생솔무현저성차이(P>0.05).결론라고잡인국부침윤마취능구유효지강저척수손상환자술후동통,감경술후조동.
@@@@Objective To observe the effect of ropivacaine in infiltration anesthesia before the end of surgical procedures for postopera-tive analgesia on patients with spinal cord injury. Methods 60 patients with spinal cord injury undergoing internal fixation of spine fractures under combined general anesthesia were assigned in 3 groups, who received 0.25% ropivacaine in infiltration anesthesia (group RL, n=20), 0.5% ropivacaine in infiltration anesthesia (group RM, n=20), or no infiltration anesthesia (group C, n=20) before the end of surgical proce-dures. The time for post-anesthesia recovery (PART), agitation score (AS), and Visual Analogue Score (VAS) for pain 2 h, 6 h, 24 h, and 48 h post operation were recorded, and related side effects were observed. Results AS within 6 h postoperation was significantly less in group RL and RM than in group C (P<0.05), as well as VAS, PART, mean of arterial pressure and heart rate 2 h, 6 h, and 24 h post operative (P<0.05).There was no significant difference in side effects including postoperative nausea and vomiting, and pruritus among these groups (P>0.05). Conclusion Ropivacaine in infiltration anesthesia would provide better postoperative analgesia, decrease the incidence of postopera-tive agitation, and increase the safety of patients with spinal cord injury in the postoperative period.