颈椎后路术后切口罗哌卡因局部浸润联合静脉自控镇痛的临床研究

目的探讨罗哌卡因局部浸润联合氯诺昔康静脉自控镇痛(PCIA)在颈椎后路术后镇痛的效果。方法择期行颈椎后路手术的患者40例,随机均分为罗哌卡因复合氯诺昔康组(L组)和单纯氯诺昔康组(C组),均采用静-吸复合麻醉。L组缝皮前用0.5%罗哌卡因20ml浸润切口周围,术毕两组均静脉注射(>15s)氯诺昔康8mg,术后均行氯诺昔康PCIA。记录术后4、8、12、24、48h的疼痛VAS评分,PCIA冲击总量,追加镇痛药使用情况以及相关不良反应。结果术后4、12、24、48hL组VAS评分明显低于C组(P<0.05)。L组PCIA冲击总量少于C组(P<0.01)。结论罗哌卡因切口局部浸润联合氯诺昔康PCIA应用于颈椎后路术后镇痛效果优于单纯氯诺昔康PCIA。

The analgesic efficacy of ropivacaine incision infiltration together with PCIA after posterior cervical spine surgery

Objective To evaluate the feasibility of postoperative ropivacaine local infiltration combined with patients controlled intravenous analgesia (PCIA) in posterior cervical spine surgery.Methods Forty patients undergoing posterior cervical spine surgeries were randomized into two groups (group L and C) with 20 each. Patients in group L received 20 ml of 0.5% ropivacaine local infiltration before skin closure. Patients in both groups received lornoxicam 8 mg intravenously as a loading dose followed by PCIA (lornoxicam 16 mg/dl). Visual analog scores (VAS) were recorded at 4, 8, 12, 24 and 48 h postoperatively. Total bolus dosage, additional analgesics and complications were also compared.Results VAS scores in group L were significantly lower than that in group C at 4, 12, 24, 48 h postoperatively (P<0.05). Total bolus dosages in group L were significantly less than that in group C (P<0.01).Conclusion Ropivacaine local infiltration combined with lornoxicam for PCIA can be safely and efficiently used in posterior cervical spine surgery.