不同浓度的罗哌卡因胸椎旁神经阻滞在胸科手术中的效果分析

Analysis on Effect of Thoracic Paravertebral Nerve Block with Different Concentration of Ropivacaine in Thoracic Surgery

目的探讨不同浓度的罗哌卡因胸椎旁神经阻滞在胸科手术中的效果。方法选取我院2021年1月至2024年3月在本院接受胸外科手术的80例患者,按照罗哌卡因用量分为A组(n=30,罗哌卡因浓度0.25%)、B组(n=30,罗哌卡因浓度0.50%)、C组(n=30,罗哌卡因浓度0.75%)。比较三组的疼痛程度、苏醒时间、拔管时间、血管活性药物用量。结果A组、B组、C组术后2 h、12 h在静息及咳嗽状态下VAS评分均低于术后即刻,且B组、C组VAS评分低于A组(P<0.05)。C组苏醒时间及拔管时间长于A组、B组(P<0.05)。C组、B组、A组舒芬太尼应用剂量依次升高,间羟胺应用剂量依次降低(P<0.05)。结论0.50%罗哌卡因胸椎旁阻滞对胸外科手术患者的镇痛效果较好,利于患者术后苏醒及恢复,减少术中镇痛及血管活性药物的应用剂量。

Objective To explore the effect of thoracic paravertebral nerve block with different concentrations of ropivacaine in thoracic surgery.Methods 80 patients undergoing thoracic surgery in our hospital from January 2021 to March 2024 were divided into group A(n=30,ropivacaine concentration 0.25%),group B(n=30,ropivacaine concentration 0.50%)and group C(n=30,ropivacaine concentration 0.75%)according to the ropivacaine dosage.The pain degree,wake-up time,extubation time and vasoactive drug dosage of the three groups were compared.Results The VAS scores of group A,group B and group C at rest and cough at 2 and 12 h after surgery were lower than those immediately after surgery,and the VAS scores of group B and group C were lower than those of group A(P<0.05).The wake-up time and extubation time of group C were longer than those of group A and group B(P<0.05).The dosage of sufentanil in group C,group B and group A increased in turn,while the dosage of m-bitartrate decreased in turn(P<0.05).Conclusions 0.50%ropivacaine in thoracic paravertebral block in thoracic surgery patients has better analgesic effect,which is conducive to postoperative awakening and recovery,and reduces the dosage of intraoperative analgesics and vasoactive drugs.