盐酸罗哌卡因和酮咯酸氨丁三醇在鼻内镜术后镇痛中的应用研究

Application of ropivacaine hydrochloride and ketorolac tromethamine for postoperative analgesia after nasal endoscopy

目的 评估鼻内镜手术中酮咯酸氨丁三醇超前镇痛联合盐酸罗哌卡因的镇痛效果。方法 收集2021年11月至2022年11月在嘉兴市第一医院接受鼻内镜手术的112例患者,按随机数字表法分为联合组(37例)、单用组(37例)和对照组(38例)。联合组在麻醉前10 min予3.00%酮咯酸氨丁三醇1 mL,术后使用0.75%盐酸罗哌卡因5 mL注入膨胀海绵填塞术腔;单用组仅术后使用0.75%盐酸罗哌卡因;对照组术后使用0.90%氯化钠注射液。比较3组术后数字疼痛量表(NRS)、布鲁格曼舒适度量表(BCS)、匹兹堡睡眠质量指数量表(PSQI)评分以及不良反应和需补充镇痛药的情况。结果 联合组在术后4、8、12 h的NRS评分最低,BCS评分最高,且在术后3 d的PSQI评分最佳;与对照组和单用组相比,联合组术后不良反应发生率最低,补充镇痛药物患者人数最少,差异均有统计学意义(均P<0.05)。结论 鼻内镜手术中,酮咯酸氨丁三醇超前镇痛联合盐酸罗哌卡因可提高术后镇痛效果、舒适度,并减少不良反应,值得临床推广。

Objective To assess the analgesic efficacy of ketorolac tromethamine combined with ropivacaine hydrochloride in nasal endoscopy.Methods A total of 112 patients undergoing nasal endoscopy at Jiaxing First Hospital from November 2021 to November 2022 were randomly assigned into three groups patients in combination group(n=37)received 1 mL of 3.00% ketorolac tromethamine 10 min before anesthesia and 5 mL of 0.75% ropivacaine postoperatively,patients in ropivacaine group(n=37) received 0.75% ropivacaine only,and patients in the control group(n=38) received 0.90% saline.Postoperative numerical rating scale(NRS),Bruggrmann comfort scale(BCS),Pittsburgh sleep quality index(PSQI),adverse reactions,and additional analgesic needs were compared among three groups.Results The combination group showed the lowest NRS scores and highest comfort levels at 4,8,and 12 h postoperatively,with the best sleep quality over the following 3 days,with fewer needs of additional analgesics and lowest rate of adverse reactions(P<0.05) compared to the other two groups.Conclusion Preemptive analgesia with ketorolac tromethamine and ropivacaine hydrochloride in nasal endoscopy improves postoperative pain relief and comfort while reducing adverse reactions,which merits clinical adoption.