地佐辛混合低浓度罗哌卡因在结直肠癌腹腔镜手术腹横肌平面阻滞应用.docVIP

地佐辛混合低浓度罗哌卡因在结直肠癌腹腔镜手术腹横肌平面阻滞应用 　　【摘要】 目的：探?地佐辛混合低浓度罗哌卡因在结直肠癌腹腔镜手术腹横肌平面阻滞方面的应用价值。方法：回顾性分析2015年9月-2017年6月本院接受结直肠癌腹腔镜根治术的直肠癌患者192例的临床资料。依据术后腹横肌平面阻滞镇痛方案的不同将其分为对照组和观察组，各96例。两组均行相同的舒芬太尼静脉自控镇痛（PCIA），对照组采用常规术后阻滞镇痛（罗哌卡因+氯化钠注射液），观察组采用地佐辛混合低浓度罗哌卡因术后阻滞镇痛。观察两组术后1、3、6、12、2 4h（T1、T2、T3、T4、T5）的镇痛效果（VAS评分）；比较两组首次按压镇痛泵时间（T）、PCIA有效按压次数（D1）、PCIA按压总次数（D2）以及舒芬太尼使用量（V）。结果：两组T1、T5时的VAS评分比较，差异均无统计学意义（P0.05）；观察组T2、T3、T4时的VAS评分均低于对照组（P0.05）；观察组V、D1、D2均少于对照组，T多于对照组，比较差异均有统计学意义（P0.05）。结论：对于实施腹腔镜手术腹横肌平面阻滞的直肠癌患者行地佐辛混合低浓度罗哌卡因阻滞镇痛不仅能够显著提升镇痛效果、延长镇痛时间，而且能够有效减少舒芬太尼用量，值得推广应用。 　　【关键词】 地佐辛； 结直肠癌； 腹横肌平面阻滞； 低浓度罗哌卡因； 镇痛效果； PCIA 　　【Abstract】 Objective：To explore the application value of Dezocine mixed with low concentration Ropivacaine in laparoscopic surgery for colorectal cancertransversus abdominis plane block.Method：The clinical data of 192 patients with colorectal cancer undergoing laparoscopic radical resection of colorectal cancer from September 2015 to June 2017 in our hospital were retrospectively analyzed.According to the different postoperative analgesic regimen of transversus abdominis plane block，they were divided into control group and observation group，96 cases in each group.They were treated of PCIA with Sufentanil，the control group received routine postoperative analgesia（Ropivacaine + Sodium Chloride Injection），and observation group received Dezocine mixed with low concentration of Ropivacaine for postoperative analgesia.The analgesic effects（VAS score） of 1，3，6，12，24 h（T1，T2，T3，T4，T5） after operation in two groups were observed.The time of pressing the pain pump for the first time（T），PCIA effective press times（D1），PCIA press total number of times（D2） and the use of sufentanil（V） between two groupswere compared.Result：The VAS score of T1 and T5 in two groupswere compared，the differences were not statistically significant（P0.05），the VAS score of T2，T3 and T4 in observation group were lower than those of control group（P0.05）.The V，D1 and D2 in observation group were less than those of co