切口局麻浸润对持续输注瑞芬太尼患者术后痛觉过敏的预防效果观察

Effects of incision local anesthesia infiltration on postoperative hyperalgesia in patients with continuous infusion of remifentanil

目的探讨切口局麻浸润对持续输注瑞芬太尼患者术后痛觉过敏的预防效果。方法选取2019年1月—2019年12月于青海红十字医院择期行肝脏肿瘤开腹切除术的68例患者为研究对象,按照随机数字表法分为两组,每组各34例。观察组患者术后关腹时对切口进行局麻浸润,对照组患者术后关腹时不做任何麻醉处理。记录两组患者术毕、术后30 min、60 min、90 min时的BCS及VAS评分,并记录舒芬太尼用量、追加镇痛例数以及不良反应发生情况。结果观察组术后各时间点BCS评分均显著高于对照组(P<0.05),VAS评分均显著低于对照组(P<0.05)。观察组术后1 h、1 d、2 d的舒芬太尼用量均明显低于对照组,且追加镇痛例数均明显少于对照组,差异具有统计学意义(P<0.05)。结论切口局麻浸润对持续输注瑞芬太尼患者术后痛觉过敏有一定的预防作用,可提升患者的舒适度,且无明显不良反应。

Objective To investigate the effects of incision local anesthesia infiltration on the prevention of postoperative hyperalgesia in patients with continuous infusion of remifentanil.Methods A total of 68 patients who underwent open resection of liver tumors in Qinghai Red Cross Hospital between January 2019 and December 2019 were selected as the research subjects.They were divided into two groups by the random number table method, with 34 cases in each group. Observation group: patients got local anesthesia infiltration at the incision when the abdomen was closed after operation. Control group: no anesthesia was done when the abdomen was closed after operation. Record the scores of Bruggrmann comfort scale (BCS) and visual analogue scale (VAS) of patients right after surgery and at 30, 60, 90 min after surgery, as well as the amount of sufentanil, the number of additional analgesia, the occurrence of adverse reactions.Results The BCS score of the observation group was higher than that of the control group at all time points after operation(P<0.05), and the VAS score of the observation group was lower than that of the control group at all time points after operation(P<0.05). Sufentani dosage in the observation group at postoperative 1 h, 1 d, and 2 d was significantly lower than that in the control group respectively, and the number of patients with additional analgesia was less than that in the control group(P<0.05).Conclusion Incision local anesthesia infiltration can prevent postoperative hyperalgesia of patients with remifentanil infusion, and improve the comfort of patients without obvious adverse reactions.