联合镇痛在乳腺局麻手术中及手术后的镇痛效果观察.docVIP

精品论文 参考文献 联合镇痛在乳腺局麻手术中及手术后的镇痛效果观察 陈晓晓 邢华 通讯作者 　　吉林大学中日联谊医院乳腺外科 吉林长春 130000 　　【摘 要】目的：观察联合镇痛在乳腺局麻手术中及手术后的镇痛效果。方法：选择可行局麻手术的各类乳腺患者，随机分成实验组80例，对照组80例，实验组用罗哌卡因和利多卡因联合镇痛，对照组用单一利多卡因局部浸润麻醉。比较观察2组患者术中追加局麻药的次数，术后疼痛视觉模拟评分（visual analog scale VAS）【1】及辅助使用止痛药的次数。进行统计学处理。结果：实验组术中追加局麻药的次数明显低于对照组，并且实验组术后VAS评分及辅助使用止痛药次数也均明显低于对照组。两者之间的差异有统计学意义。结论：联合镇痛应用于乳腺局麻手术，镇痛效果良好，值得推广。 　　【关键词】联合镇痛；乳腺手术；局部麻醉；镇痛效果 　　【中图分类号】R47 【文献标识码】B 【文章编号】1674-8999（2015）8-0492-01 　　Clinical observation on analgesic effect of combined analgesia in the breast surgery and after surgery 　　CHEN Xiao-xiao, XING Hua 　　China-Japan Union Hospital of Jilin University, Chang chun 130033, China 　　【ABSTRACT】OBJECTIVE:TO observe the analgesic effect of combined analgesia in the breast surgery and after surgery. METHODS: One hundred sixty female patients scheduled for breast operation under local anesthesia were randomly allocated to receive either combined anesthesia with ropivacaine and lidocaine (experimental group, n=80) or lidocaine alone (control group, n=80).2 groups, patients were comparatively observed with times of additional local anesthetics during surgery, pain visual analog scale (VAS) [1] and times of painkillers using after surgery. RESULTS: Times of additional local anesthetics during surgery, the VAS scores and times of painkillers using after surgery in combined anesthesia group was lower than the control group, there was statistical difference. CONCLUSIONS: The combined analgesia is effective on patients having breast surgery under local anesthesia, which is worth popularizing. 　　【KEY WORDS】 Combined analgesia; Breast surgery; Local anesthesia; Analgesic effect 　　乳腺疾病是困扰女性的最常见疾病之一，且由于乳腺癌发病率逐年增高，引起了人们对乳腺疾病的认识和重视度普遍提高。因此，各种乳腺疾病的检出率明显提高，其中很大一部分乳腺疾病需要手术干预。乳腺手术大多数可以在局部麻醉下完成，但既往的麻醉方法多有镇痛不完全，既增加患者痛苦又影响手术操作。【2】本研究以乳腺局麻手术病人为观察对象，评价联合镇痛的效果，以减轻患者痛苦，促进早期康复。 　　1 资料与方法 　　1.1 一般资料 2014年5月至2014年12月，收集我院乳腺外科收治的乳腺局麻手术患者160例，，其中年龄 17 ～ 62 岁，平均41.6岁。入选标准：（1）ASA分级为 I～Ⅱ级；（2）无心肺系统疾病；（3）无肝、肾及凝血功能异常；（4）无局麻药过敏史；（5）无孕妇及