罗哌卡因和利多卡因在局麻下老年腹股沟疝手术中的应用研究

目的对比研究罗哌卡因和利多卡因在局麻下老年腹股沟疝手术中的效果。 方法选择2017年1月至2018年12月，广东省湛江市第二人民医院行择期局麻下Lichtenstein无张力疝修补术的老年患者90例，随机平均分为试验组（罗哌卡因组）和对照组（利多卡因组），每组45例。2组患者均接受Lichtenstein无张力疝修补术，试验组患者接受0.5%罗哌卡因局部浸润阻滞麻醉，对照组患者接受1%利多卡因局麻。观察并记录2组患者基本生命体征、手术时间、术中出血、术后住院时间、局麻药起效时间、止痛持续时间、术后VAS疼痛评分和并发症发生率。 结果2组患者各时间点平均动脉压、心率和脉氧饱和度的组间及组内差异无统计学意义（P>0.05）。2组患者手术时间和术中出血量比较差异无统计学意义（P>0.05）；试验组患者术后住院时间显著低于对照组患者（P<0.05）。试验组患者局麻药起效时间和止痛持续时间均显著长于对照组（P<0.05）；手术结束当时（T4）2组患者疼痛视觉模拟评分（VAS）差异无统计学意义（P>0.05），试验组患者术后4 h（T5）的VAS疼痛评分显著低于对照组（P<0.05）。2组患者相关并发症的发生率比较差异无统计学意义（P>0.05）。 结论罗哌卡因用于局醉下行腹股沟无张力疝修补术的麻醉效果满意，其安全性高，患者术后疼痛轻，恢复快，并发症少，值得在临床推广。

Application study of ropivacaine versus lidocaine in elderly inguinal hernia surgery under local anesthesia

ObjectiveTo compare the effect of ropivacaine or lidocaine in elderly inguinal hernia surgery under local anesthesia. MethodsFrom January 2017 to December 2018, 90 elderly patients undergoing Lichtenstein tension-free hernia repair under local anesthesia in Second People's Hospital of Zhanjiang were randomly divided into experimental group (ropivacaine group) and control group (lidocaine group), with 45 cases in each group. Both groups received Lichtenstein tension-free hernioplasty. The experimental group received 0.5% ropivacaine local infiltration anesthesia, while the control group received 1% lidocaine local anesthesia. The basic vital signs, operation time, intraoperative bleeding, postoperative hospital stay, onset time of local anesthetics, duration of pain relief, postoperative VAS pain score and incidence of complications were observed and recorded. ResultsThere were no significant differences in mean arterial pressure, heart rate and pulse oxygen saturation between and within the two groups (P>0.05). There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). The postoperative hospital stay in the experimental group was significantly lower than that in the control group (P<0.05). The onset time and pain relief duration of local anesthetics in the experimental group were significantly longer than those in the control group (P<0.05). At the end of operation (T4), there was no significant difference in VAS between the two groups (P>0.05), and the VAS pain score at 4 hours (T5) in the experimental group was significantly lower than that in the control group (P<0.05). There was no significant difference in the incidence of related complications between the two groups (P>0.05). ConclusionRopivacaine for tension-free inguinal hernia repair under local intoxication has satisfactory anesthetic effect, high safety, less postoperative pain, quick recovery and fewer complications. It is worthy of clinical promotion.