摘要
目的探讨含罗哌卡因的膨胀液在吸脂术中的有效性。方法选择2015年1月~2017年1月因下肢淋巴水肿择期行吸脂术60例,随机分为2组各30例,分别用2%利多卡因25 ml(L组)或0.75%罗哌卡因30 ml(R组),加入碳酸氢钠1.5 g、肾上腺素3 mg和生理盐水配制成3000 ml膨胀液。记录2组诱导前(T_0)、注射膨胀液前(T_1)、术毕(T_2)和拔除气管导管时(T_3)的平均动脉压(MAP)和心率(HR);记录拔除气管导管时(T_3)、术后1 h(T_4)、2 h(T_5)、6 h(T_6)、12 h(T_7)和24 h(T_8)各时间点疼痛视觉模拟评分(VAS)和追加镇痛药物例数。结果 2组术中MAP、HR无统计学差异(P>0.05)。在T_4、T_5、T_6和T_7时间点,R组VAS评分低于L组[T_4:(2.2±0.8)分vs.(4.1±0.6)分,t=-10.226,P=0.000;T_5:(2.3±0.8)分vs.(4.2±0.6)分,t=-9.517,P=0.000;T_6:(2.7±0.8)分vs.(4.4±0.7)分,t=-8.932,P=0.000;T_7:(2.8±0.9)分vs.(3.6±0.6)分,t=-3.981,P=0.000]。在T_4、T_5和T_6时间点,R组追加镇痛药物例数少于L组[T_4:2例vs.9例,χ~2=5.455,P=0.020;T_5:2例vs.12例,χ~2=9.317,P=0.002;T_6:3例vs.11例,χ~2=5.963,P=0.015]。结论在吸脂手术中含罗哌卡因的膨胀液具有较高的安全性,并可提供良好的术后镇痛。
Objective To observe the effectiveness of the expansive fluid containing ropivacaine in liposuction surgery.Methods A total of 60 patients with lower limb lymphedema undergoing liposuction were randomly divided into 2 groups： Lidocaine group（ group L,n = 30） and ropivacaine group（ group R,n = 30）. The expansive fluid consisted of 2% lidocaine 25 ml（ group L）or 0. 75% ropivacaine 30 ml（ group R）,which were added respectively into 3000 ml expansive solution with 1. 5 g sodium bicarbonate and 3 mg epinephrine. The mean arterial pressure（ MAP） and heart rate（ HR） were recorded in both groups at the following time points： before induction（ T0）,before injection of expansion liquid（ T1）,at the end of the surgery（ T2）,and at the time of tracheal extubation（ T3）. The Visual Analogue Scale（ VAS） scores and the number of patients using analgesics were recorded in both groups at the each time point： at the time of tracheal extubation（ T3）,1 h（ T4）,2 h（ T5）,6 h（ T6）,12 h（ T7） and 24 h（ T8） after surgery. Results The MAP and HR during operation had no statistical differences between the two groups. The VAS scores were lower in the group R than those in the group L at T4,T5,T6 and T7[T4：（ 2. 2 ± 0. 8） vs.（ 4. 1 ± 0. 6） points,t =-10. 226,P =0. 000; T5：（ 2. 3 ± 0. 8） vs.（ 4. 2 ± 0. 6） points,t =-9. 517,P = 0. 000; T6：（ 2. 7 ± 0. 8） vs.（ 4. 4 ± 0. 7） points,t =-8. 932,P = 0. 000; T7：（ 2. 8 ± 0. 9） vs.（ 3. 6 ± 0. 6） points,t =-3. 981,P = 0. 000]. The number of patients requiring analgetics were less in the group R than those in the group L at T4,T5 and T6（ T4： 2 cases vs. 9 cases,χ-2= 5. 455,P = 0. 020; T5： 2 cases vs. 12 cases,χ-2= 9. 317,P = 0. 002; T6： 3 cases vs. 11 cases,χ-2= 5. 963,P = 0. 015）. Conclusion The expansion fluid of ropivacaine has high safety during liposuction surgery and can provide good postoperative analgesia.
作者
张海静
赵斌江
周茁
盛崴宣
Zhang Haijing, Zhao Binjiang, Zhou Zhuo, et al.(Department of Operation and Anaesthesia, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, Chin)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第7期604-606,623,共4页
Chinese Journal of Minimally Invasive Surgery
基金
北京市自然科学基金(7122085)
关键词
淋巴水肿
罗哌卡因
术后镇痛
Lymphedema
Ropivacaine
Postoperative analgesia
