罗哌卡因注射液复合舒芬太尼注射液用于单切口中下段食管癌切除术患者的临床研究

Clinical trial of ropivacaine injection combined with sufentanil injection in the treatment of patients with resection of middle and lower esophageal cancer for single incision

目的观察罗哌卡因注射液复合舒芬太尼注射液用于单切口中下段食管癌切除术患者的临床疗效及安全性。方法将115例患者根据麻醉方案分为对照组55例和试验组60例。2组患者均给予0.05 mg·kg^(-1)咪唑安定+0.15~0.20 mg·kg^(-1)依托咪酯+3~5μg·kg^(-1)芬太尼+罗库溴铵50 mg顺序静脉推注进行麻醉诱导,供氧辅助通气3 min后插管。对照组给予4~6 mg·kg^(-1)异丙酚+3~10μg·kg^(-1)瑞芬太尼+顺阿曲库铵10 mg·h^(-1)进行麻醉维持。在麻醉插管后,试验组给予0.375%罗哌卡因复合舒芬太尼10μg于T7、8椎旁各点注射6 mL进行神经阻滞。比较2组患者单肺通气2 h(T_(3))及术后(T_(4))的平均动脉压和氧分压(PaO_(2))等,以及药物不良反应的发生情况。结果试验组T_(3)和T_(4)的心率分别为(70.05±5.03)和(70.54±4.84)beat·min^(-1),PaO_(2)分别为(94.13±2.04)和(95.18±1.97)mmHg;对照组T_(3)和T_(4)的心率分别为(76.60±5.03)和(78.10±4.88)beat·min^(-1),PaO_(2)分别为(90.05±2.06)和(89.82±1.96)mmHg;2组患者相同时间点的上述指标比较,差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应有恶心呕吐和头痛,对照组发生的药物不良反应有恶心呕吐、头痛和头晕。试验组和对照组的总药物不良反应发生率分别为6.67%和10.91%,差异无统计学意义(P>0.05)。结论罗哌卡因注射液复合舒芬太尼注射液用于单切口中下段食管癌切除术患者的临床疗效确切,其有利于稳定患者的血流动力学,保护患者的肺功能,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of ropivacaine injection combined with sufentanil injection in the treatment of patients with resection of middle and lower esophageal cancer for single incision.Methods A total of 115 patients were divided into control group(n=55 cases)and treatment group(n=60 cases)according to anesthesia plan.Two groups were induced by sequential intravenous injection of 0.05 mg·kg^(-1) midazolam+0.15-0.20 mg·kg^(-1) etomidate+3-5μg·kg^(-1) fentanyl+rocuronium 50 mg for anesthesia induction,and intubation after 3 min of oxygen-assisted ventilation.The control group was given 4-6 mg·kg^(-1) propofol+3-10μg·kg^(-1) remifentanil+cisatracurium 10 mg·h^(-1) during anesthesia maintenance.After intubation under anesthesia,the treatment group was injected with 6 mL of 0.375%ropivacaine combined with sufentanil 10μg at T7 and T8 paravertebral points for nerve block.The mean arterial pressure and partial pressure of oxygen(PaO_(2))after one-lung ventilation for 2 hours(T3)and postoperative(T4),and adverse drug reactions were compared between two groups.Results The heart rates of T3 and T4 in the treatment group were(70.05±5.03)and(70.54±4.84)beat·min^(-1),PaO_(2) were(94.13±2.04)and(95.18±1.97)mmH g;the heart rates of T3 and T4 in the control group were(76.60±5.03)and(78.10±4.88)beat·min^(-1),PaO_(2) were(90.05±2.06)and(89.82±1.96)mmH g;there were statistically significant differences in the above indexes between the two groups at the same time point(all P<0.05).The adverse drug reactions of treatment group were nausea,vomiting and headache,while those in the control group were nausea,vomiting,headache and dizziness.The total incidences of adverse drug reactions in the treatment and control groups were 6.67%and 10.91%without significant difference(P>0.05).Conclusion Ropivacaine injection combined with sufentanil injection for single incision resection of middle and lower segment esophageal cancer has an exact clinical effect,which is beneficial to stabilize the hemodynamics of patients,protect the lung function of patients,without increasing the incidence of adverse drug reactions.