CAJ | 학술논문

目的：对比研究低浓度罗哌卡因、布比卡因、利多卡因在烧伤手术患者头部取皮后的镇痛效果。方法84例烧伤后切削痂植皮的患者采用头部取皮法，随机分为4组( n=21)，其中常规对照组( C组)按既往常规方法在头皮下注入含1/200000的肾上腺素生理盐水200 mL进行头皮下扩张，罗哌卡因组(R组)0.05%罗哌卡因200 mL进行头皮下局麻并扩张头皮，布比卡因组(B组)0.188%布比卡因头皮下局麻，利多卡因组(L组)0.1%利多卡因头皮下局麻；分别于麻醉开始前(T0)、手术结束患者清醒后20 min(T1)、5 h(T2)和10 h(T3)时采用肌肉活动评分法(MAAS)进行意识状态评价，并采用视觉模糊评分(VAS)对头部及躯体创面分别进行疼痛评估，全程监测心率、血压等生命体征进行安全性评价。结果4组患者均安全度过围手术麻醉期，其中R组患者在3个时间点VAS评分均明显低于其余3组。结论头皮下低浓度罗哌卡因注射更适合应用于患者头皮取皮后的镇痛。
목적：대비연구저농도라고잡인、포비잡인、리다잡인재소상수술환자두부취피후적진통효과。방법84례소상후절삭가식피적환자채용두부취피법，수궤분위4조( n=21)，기중상규대조조( C조)안기왕상규방법재두피하주입함1/200000적신상선소생리염수200 mL진행두피하확장，라고잡인조(R조)0.05%라고잡인200 mL진행두피하국마병확장두피，포비잡인조(B조)0.188%포비잡인두피하국마，리다잡인조(L조)0.1%리다잡인두피하국마；분별우마취개시전(T0)、수술결속환자청성후20 min(T1)、5 h(T2)화10 h(T3)시채용기육활동평분법(MAAS)진행의식상태평개，병채용시각모호평분(VAS)대두부급구체창면분별진행동통평고，전정감측심솔、혈압등생명체정진행안전성평개。결과4조환자균안전도과위수술마취기，기중R조환자재3개시간점VAS평분균명현저우기여3조。결론두피하저농도라고잡인주사경괄합응용우환자두피취피후적진통。
Objective To investigate the different effect among ropivacaine,bupivacaine,lidocaine on analgesia after harvesting grafts from the scalp in burn patients. Methods 84 patients who need harvesting grafts from the scalp after burn were divided in 4 groups random-ly(n=21). Patients in group C hypodermically injected with saline 200 mL were control,while patients in group R injected with 0. 05% ropi-vacaine 200 mL,group B with 0. 188% bupivacaine,and group L with 0. 1% lidocaine. Motor activity assessment scale( MAAS) and visual analogue scale(VAS) were made before anesthesia(T0) and 20 min,5 h,10 h after awake of patients. VAS were made focus on head and body in part. Vital signs were also monitored and recorded for assessment of security. Results All patients in 4 groups had passed the period of operation safely. Patients in group R have better VAS than other groups. Conclusion Low concentration ropivacaine hypodermically injec-tion of head is helpful to relieve the pain after harvesting grafts from the scalp.