应用罗哌卡因局部浸润对腹腔镜胆囊切除术患者镇痛作用分析.docVIP

应用罗哌卡因局部浸润对腹腔镜胆囊切除术患者镇痛作用分析 　　[摘要] 目的 研究?_哌卡因局部浸润对腹腔镜胆囊切除术的镇痛作用。 方法 选取2015年4月～2016年8月我院择期全麻下行腹腔镜胆囊切除术患者80例。根据麻醉方法分为观察组与对照组各40例。观察组在切皮前分别注入盐酸罗帕卡因4mL于脐部切口、肋缘下切口以及剑突下切口，手术完毕前给予腹腔均匀喷洒20mL罗哌卡因，对照组患者则不给予罗哌卡因处理。分别比较两组各项手术指标，术后24h血压、心率、血氧饱和度水平，术后不同时间段疼痛情况，额外加用镇痛药物情况以及不良反应发生率。 结果 两组手术时间、苏醒时间、喉罩拔除时间对比均不明显（P0.05）。两组术后24h血压、心率、血氧饱和度水平对比均不明显（P0.05）。观察组在术后4、8、12h的VAS评分分别为（3.1±1.3）、（2.4±1.0）、（1.1±0.3）分，均显著低于对照组的（3.9±1.7）、（3.3±1.4）、（1.7±0.6）分。观察组患者额外镇痛药物使用率为12.50%（5/40），显著低于对照组的47.50%（19/40），差异有统计学意义（P0.05）。 结论 罗哌卡因局部浸润对缓解腹腔镜胆囊切除术患者的镇痛效果显著，可有效减少额外镇痛药物的使用率。 　　[关键词] 腹腔镜胆囊切除术；罗哌卡因；局部浸润；镇痛 　　[中图分类号] R614 [文献标识码] A [文章编号] 2095-0616（2017）09-239-03 　　Analysis on analgesic effect of local infiltration of ropivacaine on patients with laparoscopic cholecystectomy 　　SUN Jinchun 　　Second Department of Surgery，Zhongshan Sanxiang Hospital，Zhongshan 528463，China 　　[Abstract] Objective To research analgesic effect of local infiltration of ropivacaine on laparoscopic cholecystectomy. Methods 80 patients who undergoing elective laparoscopic cholecystectomy under general anesthesia from April 2015 to August 2016 were selected.They were divided into the observation group and the control group according to anesthesia methods，with 40 in each.The observation group was respectively injected 4mL hydrochloride ropivacaine at umbilical incision，subcostal incision and subxiphoid minimal incision before skin incision.Before the end of surgery，20mL ropivacaine were sprayed uniformly at abdominal cavity.Patients in the control group were not given ropivacaine.Operation indexes，blood pressure of postoperative 24h，heart rate，oxygen saturation level，postoperative pains at different time，additional use of analgesic drug and incidence of adverse reactions of two groups were respectively compared. Results Comparisons of operative time，recovery time and removal time of laryngeal mask between two groups were all not significant（P0.05）.Comparisons of blood pressure of postoperative 24h，heart rate and oxygen satur