罗哌卡因复合利多卡因及肾上腺素局部麻醉在超声引导下乳腺真空旋切术中的应用

Application of Ropivacaine Combined with Lidocaine and Epinephrine Local Anesthesia in Ultrasound Guided Vacuum Breast Gyrotomy

目的:探究罗哌卡因复合利多卡因及肾上腺素局部麻醉在超声引导下乳腺真空旋切术中的应用。方法:选取2020年9月—2023年9月景德镇市第三人民医院收治的85例需行手术的乳腺肿块患者,采用随机数字表法分为研究组(n=43)和对照组(n=42)。两组均在超声引导下行乳腺真空旋切术,对照组给予利多卡因及肾上腺素局部麻醉,研究组给予罗哌卡因复合利多卡因及肾上腺素局部麻醉。比较两组手术一般情况、疼痛情况、血流动力学指标及术后并发症发生情况。结果:研究组术中出血量少于对照组,术后创面愈合时间短于对照组,差异均有统计学意义(P<0.05)。术后2、24 h,研究组视觉模拟评分法(VAS)评分均低于对照组,差异均有统计学意义(P<0.05)。术后,研究组前列腺素E2(PGE2)、P物质(SP)及去甲肾上腺素(NE)水平均低于对照组,差异均有统计学意义(P<0.05)。术后,对照组心率(HR)、平均动脉压(MAP)均低于术前,但研究组HR、MAP均高于对照组,差异均有统计学意义(P<0.05)。研究组并发症总发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:采用罗哌卡因复合利多卡因及肾上腺素局部麻醉,能有效降低超声引导下乳腺真空旋切术患者的术中出血量,缩短术后创面愈合时间,降低术后疼痛,维持血流动力学稳定,术后并发症较少。

Objective:To explore the application of Ropivacaine combined with Lidocaine and Epinephrine local anesthesia in ultrasound guided vacuum breast gyrotomy.Method:A total of 85 patients with breast mass requiring surgery admitted to Third People's Hospital of Jingdezhen from September 2020 to September 2023 were selected and divided into study group(n=43)and control group(n=42)by random number table method.In both groups,ultrasound guided vacuum breast gyrotomy was performed.The control group was given local anesthesia with Lidocaine and Epinephrine,and the study group was given local anesthesia with Ropivacaine combined with Lidocaine and Epinephrine.The general conditions,pain,hemodynamic indexes and postoperative complications were compared between the two groups.Result:The intraoperative blood loss of the study group was less than that of the control group,and the postoperative wound healing time was shorter than that of the control group,the differences were statistically significant(P<0.05).At 2 and 24 h after operation,visual analogue scale(VAS)scores of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).After operation,the levels of prostaglandin E2(PGE2),substance P(SP)and norepinephrine(NE)in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).After operation,the heart rate(HR)and mean arterial pressure(MAP)of the control group were lower than those before operation,but the HR and MAP of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the study group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The use of Ropivacaine combined with Lidocaine and Epinephrine local anesthesia can effectively reduce the amount of intraoperative blood loss,shorten the postoperative wound healing time,reduce postoperative pain,maintain stable hemodynamics,and reduce Medical Innovation of China Vol.21,No.33 November,2024 postoperative complications in patients undergoing ultrasound guided vacuum breast gyrotomy.