[1]林雪玫,林淡容,吴 浩,等.布托啡诺联合罗哌卡因佐剂行竖脊肌平面阻滞对胸腔镜肺癌根治术后的镇痛效果[J].医学信息,2021,34(02):82-85.[doi:10.3969/j.issn.1006-1959.2021.02.022]
　LIN Xue-mei,LIN Dan-rong,WU Hao,et al.Analgesic Effect of Butorphanol Combined with Ropivacaine Adjuvant for Erector Spinal Muscle Plane Block After Thoracoscopic Radical Resection of Lung Cancer[J].Medical Information,2021,34(02):82-85.[doi:10.3969/j.issn.1006-1959.2021.02.022]
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布托啡诺联合罗哌卡因佐剂行竖脊肌平面阻滞对胸腔镜肺癌根治术后的镇痛效果()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年02期
页码:
82-85
栏目:
论著
出版日期:
2021-01-15

文章信息/Info

Title:
Analgesic Effect of Butorphanol Combined with Ropivacaine Adjuvant for Erector Spinal Muscle Plane Block After Thoracoscopic Radical Resection of Lung Cancer
文章编号:
1006-1959（2021）02-0082-04
作者:
林雪玫; 林淡容; 吴 浩; 等
（揭阳市第三人民麻醉科，广东 揭阳 522000）
Author(s):
LIN Xue-mei; LIN Dan-rong; WU Hao; et al.
(Department of Anesthesiology,Jieyang Third People’s Hospital,Jieyang 522000,Guangdong,China)
关键词:
布托啡诺; 罗哌卡因; 竖脊肌平面阻滞; 胸腔镜肺癌根治术; 术后镇痛
Keywords:
Butorphanol; Ropivacaine; Erector spinal muscle plane block; Thoracoscopic radical resection of lung cancer; Postoperative analgesia
分类号:
R614；R734.2
DOI:
10.3969/j.issn.1006-1959.2021.02.022
文献标志码:
A
摘要:
目的 观察布托啡诺联合罗哌卡因佐剂行竖脊肌平面阻滞用于胸腔镜肺癌根治术后镇痛的效果。方法 选择2018年10月~2020年8月在我院行择期胸腔镜肺癌根治术的患者50例，采用随机数字法分为布托啡诺组（B组）和罗哌卡因组（R组），每组25例。两组均采用支气管插管全身麻醉，麻醉诱导前行竖脊肌平面阻滞，术后采用静脉自控镇痛。竖脊肌平面阻滞使用药物：B组为布托啡诺2 mg+罗哌卡因150 mg+生理盐水稀释至30 ml，R组为罗哌卡因150 mg+生理盐水稀释至30 ml。比较两组术后2、6、12、24、48h的静息VAS评分、术后48 h内镇痛泵按压次数、首次按压镇痛泵时间、舒芬太尼使用总量和使用哌替啶补救镇痛例数、术后首次下床活动时间、术后48h内下床活动总次数、术后48 h内恶心呕吐、呼吸抑制、心动过缓等不良反应发生情况。结果 B组术后24、48h静息VAS评分低于R组，术后48h镇痛泵按压次数、舒芬太尼使用总量、使用哌替啶补救镇痛例数低于R组，差异有统计学意义（P＜0.05）；B组首次按压镇痛泵时间晚于R组，术后首次下床活动时间早于R组，术后48h内下床活动总次数高于R组，差异有统计学意义（P＜0.05）。结论 布托啡诺联合罗哌卡因佐剂行竖脊肌平面阻滞用于胸腔镜肺癌根治术后镇痛效果较好，可降低患者术后疼痛，减少术后镇痛药物的使用量，促进患者快速康复，效果优于单用罗哌卡因。
Abstract:
Objective To explore the analgesic effect of butorphanol combined with ropivacaine for erector spinae plane block after thoracoscopic radical resection of lung cancer.Methods 50 patients with lung cancer after elective thoracoscopic radical resection in our hospital were randomly divided into butorphanol group (group B) and ropivacaine group (Group R), 25 cases in each group.Both groups underwent general anesthesia with bronchial intubation, erector spinal muscle plane block before induction of anesthesia, and intravenous self-controlled analgesia after operation. The drugs used for erector spinae plane block: group B was butorphanol 2 mg+ropivacaine 150 mg+diluted to 30 ml with normal saline, group R was ropivacaine 150 mg+diluted with normal saline to 30 ml.The resting VAS scores at 2, 6, 12, 24, and 48 h after the operation, the number of times the analgesic pump was pressed within 48 h after the operation, the time of first pressing the analgesic pump, the total amount of sufentanil used and the use of pethidine were compared between the two groups The number of cases of remedial analgesia, the time of getting out of bed for the first time after surgery, the total number of getting out of bed within 48 h after surgery, nausea and vomiting within 48 hours after surgery, respiratory depression, bradycardia and other adverse reactions occurred.Results The resting VAS score of group B was lower than that of group R at 24 and 48 h after operation. The number of times of analgesic pump compression, total amount of sufentanil and pethidine used for salvage analgesia at 48 hafter operation were lower than that of group R,the difference was statistically significant (P＜0.05);The first time of pressing the analgesic pump in group B was later than that of group R, and the time of getting out of bed for the first time after operation was earlier than that of group R. The total number of getting out of bed within 48 hafter operation was higher than that of group R,the difference was statistically significant (P<0.05).Conclusion Butorphanol combined with ropivacaine adjuvant for erector spinal muscle plane block has a better analgesic effect after thoracoscopic radical resection of lung cancer, which can reduce postoperative pain and reduce the use of postoperative analgesics. Promote the rapid recovery of patients, and the effect is better than that of ropivacaine alone.

参考文献/References:

[1]孟宏伟,殷小坤.硬膜外麻醉联合全麻对非小细胞肺癌的疗效及围术期免疫功能的影响[J].实用癌症杂志,2017,32(7):1142-1145. [2]刘瑶,李冰,孟星,等.不同时机胸椎旁神经阻滞对胸腔镜肺癌根治术患者术后远期生活质量的影响[J].中华麻醉学杂志,2019,39(9):1047-1050. [3]何娟,艾艳秋,赵华平.胸椎旁神经阻滞对全麻下胸腔镜肺癌根治术患者炎症反应的影响[J].中华麻醉学杂志,2019,39(5):568-570. [4]胡继成,柴小青,疏树华,等.氟比洛芬酯联合肺保护性通气对胸腔镜肺癌根治术病人术后细胞免疫功能的影响[J].中华麻醉学杂志,2019,39(1):18-22. [5]王强,郑晖,张国华,等.胸腔镜肺癌根治术麻醉的优化策略:竖脊肌平面阻滞联合全身麻醉[J].中华麻醉学杂志,2018,38(11):1325-1327. [6]周龙媛,蔡畅,赵劲松,等.不同浓度右美托咪定混合罗哌卡因病人自控臂丛神经阻滞用于肘关节手术后镇痛的效果[J].中华麻醉学杂志,2019,39(7):835-839. [7]魏鹏,桂煜,高彬,等.右美托咪定混合罗哌卡因行腹横肌平面阻滞用于小儿术后镇痛的效果[J].中华麻醉学杂志,2018,38(6):684-686. [8]张鹤晨,张静,蔚冬冬,等.罗哌卡因复合布托啡诺腹横肌平面阻滞对妇科腹腔镜手术患者术后镇痛及早期康复的影响[J].临床麻醉学杂志,2020,36(2):156-159. [9]信文启,黄俊霞,闫增,等.布托啡诺联合隐神经阻滞对老年患者全膝关节置换术后康复的影响[J].中华麻醉学杂志,2019,39(11):1407-1408. [10]Webster LR,Brennan MJ,Kwong LM,et al.Opioidabusedeterrentstrategies:role of clinicians in acute pain management[J].Postgrad Med,2016,128(1):76-84. [11]Rawal N.Current issues in postoperative pain management[J].Eur J Anaesthesiol,2016,33(3):160-171. [12]Dizdarevic A,Fernandes A.Thoracic Paravertebral Block,MultimodalAnalgesia,and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis[J].Case Rep Anesthesiol,2016(2016):6301358. [13]Tam KW,Chen SY,Huang TW,et al.Effect of wound infiltration with ropivacaine or bupivacaine analgesia in breast cancer surgery:A meta-analysis of randomized controlledtrials[J].Int J Surg,2015(22):79-85. [14]马福国,王明山,时飞,等.多模式镇痛对老年肺癌患者术后炎性因子及呼吸功能的影响[J].中国疼痛医学杂志,2013,19(10):631-633. [15]Forero M,Adhikary SD,Lopez H,et al.The erector spinae plane block:anovel analgesic technique in thoracic neuropathic pain[J].Reg Anesth Pain Med,2016,41(5):621-627. [16]Chin KJ,Adhikary S,Sarwani N,et al.The analgesic efficacy of pre-operative bilateral erector spinae plane(ESP)blocks in patients having ventral hernia repair[J].Anaesthesia,2017,72(4):452-460. [17]Forero M,Rajarathinam M,Adhikary S,et al.Continuous erector spinae plane block for rescue analgesia in thoracotomy after epidural failure:acase report[J].A Case Rep,2017,8(10):254-256. [18]马丹旭,任惠龙,芮燕,等.超声引导下单次竖脊肌平面阻滞对胸腔镜下肺叶切除患者静脉自控镇痛效果的影响[J].临床麻醉学杂志,2017,33(10):965-967.

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更新日期/Last Update: 1900-01-01