0.375%罗哌卡因在腹腔镜胃癌根治术超声引导下竖脊肌平面阻滞中的镇痛效果及安全性

Analgesic effect and safety of 0.375%ropivacaine in ultrasound-guided plane block of vertical spinal muscle in laparoscopic radical gastrectomy

目的探讨0.375%罗哌卡因在腹腔镜胃癌根治术超声引导下竖脊肌平面阻滞中的镇痛效果及安全性。方法依据罗哌卡因的不同浓度将102例胃癌患者分为A组(n=50)和B组(n=52),A组患者给予0.375%罗哌卡因超声引导下竖脊肌平面阻滞,B组患者给予0.250%罗哌卡因超声引导下竖脊肌平面阻滞。比较两组患者的静息及运动时疼痛程度[视觉模拟评分法(VAS)]、舒适度[舒适度量表(BCS)]、术后镇痛效果(首次按压镇痛泵时间、24 h内按压次数及舒芬太尼用量)、不良反应发生情况。结果术后2、8、16、24 h,A组患者静息和运动状态下的VAS评分均低于B组,差异均有统计学意义(P﹤0.05)。术后2、8、16、24 h,A组患者的BCS评分均明显高于B组,差异均有统计学意义(P﹤0.01)。两组患者术后首次按压镇痛泵时间、术后24 h内按压次数及舒芬太尼用量比较,差异均无统计学意义(P﹥0.05)。A组患者不良反应总发生率为20.00%,与B组患者的23.08%比较,差异无统计学意义(P﹥0.05)。结论0.375%罗哌卡因在腹腔镜胃癌根治术超声引导下竖脊肌平面阻滞中的镇痛效果优于0.250%罗哌卡因,且不增加不良反应发生风险。

Objective To investigate the analgesic effect and safety of 0.375%ropivacaine in ultrasound-guided plane block of vertical spinal muscle during laparoscopic radical gastrectomy.Method A total of 102 patients with gastric cancer were divided into group A(n=50)and group B(n=52)according to the different concentrations of ropivacaine.Group A received 0.375%ropivacaine with ultrasound-guided plane block of erector spinae muscle,and group B received0.250%ropivacaine with ultrasound-guided plane block of erector spinae muscle.The degree of pain during rest and exercise[visual analogue scale(VAS)],comfort[Bruggrmann comfort scale(BCS)],postoperative analgesia effect(the time of the first press of the analgesia pump,the number of presses within 24 hours and the amount of sufentanil),and adverse reactions were compared between the two groups.Result At 2,8,16 and 24 hours after operation,the VAS scores of patients in group A were lower than those in group B at rest and exercise,the differences were statistically significant(P<0.05).At 2,8,16 and 24 hours after operation,the BCS scores of patients in group A were significantly higher than those in group B,the differences were statistically significant(P<0.01).There were no statistically significant differences between the two groups in the time of first press analgesia pump,the number of press within 24 hours after operation and the amount of sufentanil(P>0.05).The total incidence of adverse reactions in group A was 20.00%,there was no significant difference compared with 23.08%in group B(P>0.05).Conclusion The analgesic effect of 0.375%ropivacaine in ultrasound-guided plane block of vertical spine muscle in laparoscopic radical gastrectomy is better than 0.250%ropivacaine,and does not increase the risk of adverse reactions.