开胸术后不同浓度罗哌卡因胸椎旁阻滞镇痛效果的比较

Postoperative analgesic effects of thoracic paravertebral block with concentrations of ropivacaine in patients received thoracotomy

目的比较开胸手术后超声引导下不同浓度罗哌卡因胸椎旁阻滞的术后镇痛效果。方法选择开胸手术患者69例，采取抽签法随机分成3组（每组23例）：高浓度组（H组，0．375％罗哌卡因）、中等浓度组（M组，0．25％罗哌卡因）和低浓度组（L组，0．15％罗哌卡因）。术后在超声引导下行胸椎旁阻滞，记录术后各时间点静息、咳嗽和深呼吸状态下的VAS评分。结果高浓度组和中等浓度组患者在入PACU即刻的静息VAS评分及术后6h的静息、咳嗽和深呼吸状态下的VAS评分均低于低浓度组（P〈0．05）。结论0．25％罗哌卡因20ml用于开胸手术患者术毕超声引导下胸椎旁阻滞镇痛效果良好。

Objective To compare the postoperative analgesic effects of ultrasound-guided thoracic paravertebral block with concentrations of ropivacaine on patients received thoracotomy. Methods Sixty-nine patients undergoing thoracotomy were randomly divided into three groups（n=23）, respectively received high （group H, 0.375%）, medium （group M, 0.25%）, and low （group L, 0.15%） concentrations of ropivacaine. After operation, all patients received thoracic paravertebral blockade under the guidance of ultrasound. VAS during rest, coughing, and deep breath, were recorded. Results Compared with group L, the VAS during rest significantly decreased in group H and M （P〈O.05） immediately after patients entered the PACU. Furthermore, the VAS scores during rest, coughing, and deep breath in group H and M 6 h after operations declined significantly more than those in group L （P〈0.05）. Conclusions Ultrasound -guided thoracic paravertebral blockade with 20 ml 0.25% ropivacaine provided satisfying postoperative analgesic effects on patients received thoracotomy.