地塞米松联合罗哌卡因行竖脊肌平面阻滞对经皮肾镜取石患者术后疼痛的影响

目的评价超声引导下地塞米松联合罗哌卡因竖脊肌平面阻滞对经皮肾镜取石术患者术后疼痛的影响。方法选择择期行经皮肾镜取石术患者60例,随机分为2组,每组30例。均超声引导下行竖脊肌平面阻滞,对照组给予0.375%罗哌卡因30 mL,试验组给予地塞米松10 mg+0.375%罗哌卡因共30 mL,阻滞起效后进行全身麻醉诱导和维持。记录2组阻滞起效时间和消退时间、手术时间、术中丙泊酚和瑞芬太尼用量,术后评估患者疼痛视觉模拟量表(VAS)评分,观察并记录不良反应发生情况等。结果 2组手术时间、丙泊酚和瑞芬太尼用量无显著差异(P> 0.05)。与对照组相比,试验组阻滞起效时间缩短(P <0.05),阻滞消退时间延长(P <0.05)。术后1、48 h,VAS评分组间比较无显著差异(P> 0.05);术后6、12、24 h,试验组患者静息和咳嗽VAS评分显著低于对照组(P <0.05)。术后试验组使用补救性镇痛药物1例,发生恶心呕吐1例,均少于对照组(分别为9例、7例,P <0.05)。结论超声引导下地塞米松联合罗哌卡因竖脊肌平面阻滞对经皮肾镜取石术患者有良好的术后...

Influence of erector spinae plane block with dexamethasone and ropivacaine on postoperative pain in patients undergoing percutaneous nephrolithotomy

AIM To evaluate the effects of ultrasound-guided erector spinae plane block with dexamethasone and ropivacaine on the postoperative pain in patients undergoing percutaneous nephrolithotomy.METHODS Sixty patients who underwent percutaneous nephrolithotomy were divided into two groups randomly,30 patients in each group.Ultrasoundguided erector spinae plane block was performed for all patients,and the control group was given 30 mL of 0.375%ropivacaine,while the trial group was given 30 mL of dexamethasone 10 mg+0.375%ropivacaine.General anesthesia was induced and maintained after block onset.Time of onset and regression of block,operation time,intraoperative dosage of propofol and remifentanil were recorded.Postoperative pain visual analog scale(VAS)scores were evaluated,and the incidence of adverse reactions was observed and recorded.RESULTS There were no significant differences in operation time,dosage of propofol and remifentanil between the two groups(P>0.05).Compared with the control group,the onset time was shorter(P<0.05),and the duration of block regression was longer in the trial group(P<0.05).There were no significant difference in VAS scores between the two groups at 1 h and 48 h after operation(P>0.05),and the VAS scores of rest and cough at 6 h,12 h and 24 h after operation in the trial group were significantly lower than those in the control group(P<0.05).In the trial group,1 case used salvage analgesic drugs,and 1 case had nausea and vomiting,which were less than those in the control group(9 cases and 7 cases respectively,P<0.05).CONCLUSION Ultrasound-guided erector spinae plane block with dexamethasone and ropivacaine has a good postoperative analgesic effect on patients underwent percutaneous nephrolithotomy with good safety.