胸部肿瘤病人术后罗哌卡因镇痛的研究

 目的观察罗哌卡因肋间神经阻滞对胸部肿瘤病人开胸手术后镇痛的效果。方法80例ASAⅠ~Ⅱ级行开胸手术的患者随机分为两组,实验组于关胸前用罗哌卡因行切口附近胸椎处肋间神经阻滞麻醉,对照组未行此处理。两组病人术后均采用静脉病人自控镇痛泵(PCA),术后测定不同时间点的视觉疼痛评分(VAS)、记录首次应用PCA的时间、术后48hPCA有效按压次数及镇痛药累积使用量,并记录每组病人术后因肺不张而行支气管镜吸痰的人次。结果罗哌卡因肋间阻滞可以大大减轻开胸术后伤口的疼痛,减少术后镇痛药物的用量及肺不张的发生。结论罗哌卡因肋间神经阻滞使用方便,镇痛效果好,可作为常规开胸术后的镇痛方法。

Study of Ropivacaine Post-thoracotomy Pain Controlling for Patients with Thoracic Cancer

Objective 　The aim of this study was to evaluate analgesic efficacy of intercostal nerves block with ropivacaine for post2thoracotomy pain. Methods 　80 ASA physical status Ⅰ～ Ⅱpatient s undergo2 ing thoracotomy were randomly allocated into two groups ,one to receive post2thoracotomy analgesia via intercostal nerves block with ropivacaine at the end of operation ,the orther not receive intercostal nerves block. In the case of inadequate analgesia , morphine was used via patient2cont rolled analgesia ( PCA) pump ,the variables recorded were the visual analogue scale (VAS) , the number of bolus applications of morphine through PCA and the number of patient s undergoing bronchoscopy to resolve post2operation at2 electasis in each group . Results 　The postoperative pain cont rol during the first 482h period was satisfac2 tory with patient s who were administ rated with ropivacaine block ,the number of bolus application of mor2 phine and the number of patient s needing bronchoscopy was much less than that in patient s who did not undergo ropivacaine block. Conclusion 　The intercostal nerve administ ration of ropivacaine provides satis2 factory pain cont rol af ter thoracotomy.