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| 0.375%罗哌卡因不同注射速度对后入路腰方肌阻滞术后镇痛效果的影响 |
| Effect of different injection speed of 0.375% ropivacaine on postoperative analgesia of posterior approach quadratus lumbosus block |
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| DOI：10.12089/jca.2020.10.015 |
| 中文关键词: 超声引导 注射速度 腰方肌阻滞 镇痛 |
| 英文关键词: Ultrasound guidance Injection speed Quadratus lumbosus block Analgesia |
| 基金项目:江西省卫生健康委员会科技计划项目（20202109） |
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| 中文摘要: |
目的 探讨0.375%罗哌卡因不同注射速度对超声引导下后入路腰方肌阻滞术后镇痛效果的影响。
方法 拟在择期全麻下行腹腔镜Dixon直肠癌根治术患者60例，男40例，女20例，年龄35～70岁，BMI 18～30 kg/m2，ASA Ⅰ或Ⅱ级，采用随机数字表法分为两组：每侧注射速度40 ml/min组（H组）和每侧注射速度20 ml/min组（L组），每组30例。全麻诱导前行超声引导下双侧后入路腰方肌阻滞，H组和L组每侧分别以40 ml/min和20 ml/min给予0.375%罗哌卡因20 ml。术后均行舒芬太尼PCIA。记录术中舒芬太尼用量和术后镇痛泵首次按压时间。记录术后4、8、12、24 h静息、运动时VAS疼痛评分、舒芬太尼用量、补救性镇痛例数。记录内脏损伤、局麻药中毒、穿刺血肿等并发症的发生情况。
结果 与L组比较，H组术中舒芬太尼用量明显减少，术后镇痛泵首次按压时间延长（P<0.05）；术后4、8、12、24 h静息、运动时VAS疼痛评分明显降低，舒芬太尼用量明显减少（P<0.05）；补救性镇痛例数明显减少（P<0.05）。两组均无内脏损伤、局麻药中毒、穿刺血肿等并发症发生。
结论 超声引导下后入路腰方肌阻滞中，0.375%罗哌卡因注射速度40 ml/min的术后镇痛效果优于20 ml/min。 |
| 英文摘要: |
Ojective To investigate the effect of different injection speeds of 0.375% ropivacaine on the analgesic effect of ultrasound-guided posterior approach quadratus lumbosus block.
Methods Sixty patients undergoing laparoscopic Dixon rectal cancer radical resection under elective general anesthesia, 40 males and 20 females, aged 35-70 years, with a BMI 18-30 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were divided into two groups by random number table (n = 30): high speed group (group H) and low speed group (group L). Ultrasound-guided posterior approach quadratus lumbosus block was induced by general anesthesia. Group H and group L were intramuscularly injected with 20 ml of 0.375% ropivacaine at an injection rate of 40 ml/min and 20 ml/min. All patients underwent PCIA after operation, and the visual analogue scale of pain (VAS score) was ≤ 3 scores. The amount of sufentanil in the two groups, the resting and exercise VAS scores were recorded 4, 8, 12, and 24 h after surgery. The first time of analgesia pump, the dose of sufentanil, and the number of remedial analgesia were recorded. The occurrence of complications such as visceral injury, local anesthetic poisoning, and puncture hematoma was recorded.
Results Compared with group L, the intraoperative sufentanil dosage was significantly reduced, and the first compression time of the analgesic pump was prolonged in group H (P < 0.05). Compared with group L, the VAS scores during rest and exercise 4, 8, 12, and 24 h after operation were significantly reduced, the amount of sufentanil was significantly reduced, and the number of salvage analgesia was significantly reduced in group H (P < 0.05). There were no complications such as visceral injury, local anesthetic poisoning, and puncture hematoma in both groups.
Conclusion In ultrasound-guided posterior quadratus lumbar muscle block, the analgesic effect of 0.375% ropivacaine injection at 40 ml/min is better than 20 ml/min. |
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