喷他佐辛复合罗哌卡因切口浸润麻醉在胸腔镜肺叶切除术中的应用

Application of Pentazocine Combined with Ropivacaine Incision Infiltration Anesthesia in Thoracoscopic Lobectomy

目的分析喷他佐辛复合罗哌卡因切口浸润麻醉在胸腔镜肺叶切除术中的应用。方法选取2016年7月~2018年9月在我院行胸腔镜肺叶切除手术患者90例,按照随机数字表法分为试验组和对照组,各45例。对照组行罗哌卡因切口浸润麻醉及静脉自控镇痛,试验组在对照组基础上联合喷他佐辛浸润麻醉。比较两组术后苏醒时间、拔管时间、躁动评分及术后4、8、12、24、48 h时疼痛视觉模拟评分(VAS),记录两组术后48 h自控镇痛(PCA)按压次数、镇痛药用量、不良反应发生情况。结果试验组躁动评分为(1.56±0.45)分,低于对照组的(1.84±0.67)分,差异有统计学意义(P<0.05);试验组术后4、8、12、24 h的VAS评分均低于对照组,差异有统计学意义(P<0.05);试验组术后48 h的PCA按压总次数为(2.09±0.21)次、镇痛药用量为(92.82±5.49)μg,分别低于对照组的(4.72±0.39)次及(101.98±5.34)μg,差异有统计学意义(P<0.05)。结论喷他佐辛复合罗哌卡因切口浸润麻醉可起到协同镇痛作用,并延长局部镇痛作用时间,降低患者术后24 h内的疼痛程度,减少PCA按压次数及镇痛药用量,且不会增加不良反应,具有临床应用价值。

Objective To analyze the application of pentazocine combined with ropivacaine incision infiltration anesthesia in thoracoscopic lobectomy.Methods A total of 90 patients undergoing thoracoscopic lobectomy in our hospital from July 2016 to September 2018 were selected and divided into a test group and a control group according to the random number table method,each with 45 cases.The control group underwent ropivacaine incision infiltration anesthesia and vein-controlled analgesia.The test group combined with pentazocine infiltration anesthesia on the basis of the control group.Comparison of postoperative recovery time,extubation time,restlessness score and visual analogue score(VAS)of pain at 4,8,12,24,and 48 h after operation,and recording of PCA compression at 48 h after operation in both groups frequency,dosage of analgesics,and occurrence of adverse reactions.Results The agitation score of the test group was(1.56±0.45)points,which was lower than that of the control group(1.84±0.67)points,the difference was statistically significant(P<0.05);the VAS score of the test group at 4,8,12,and 24 h after surgery all were lower than the control group,the difference was statistically significant(P<0.05);The total number of PCA compressions in the test group at 48 h after surgery was(2.09±0.21)times,and the analgesic dosage was(92.82±5.49)μg,which was lower than that in the control group(4.72±0.39)times and(101.98±5.34)μg,the difference was statistically significant(P<0.05).Conclusion Pentazocine combined with ropivacaine incision infiltration anesthesia can play a synergistic analgesic effect,prolong the time of local analgesia,reduce the degree of pain within 24 h after operation,reduce the number of PCA compressions and the amount of analgesics,and will not increase adverse reactions,has clinical value.