青岛大学学报（医学版）2024，Vol.60Issue(2)：279-283,5.DOI:10.11712/jms.2096-5532.2024.60.064
不同剂量艾司氯胺酮联合罗哌卡因前锯肌平面阻滞对胸腔镜手术病人术后镇痛的影响
Efficacy of serratus anterior plane block with different doses of esketamine combined with ropivacaine in postoperative analgesia for pa-tients undergoing thoracoscopic surgery
摘要
Abstract
Objective To investigate the efficacy of serratus anterior plane block(SAPB)with different doses of esketamine combined with ropivacaine in postoperative analgesia for patients undergoing thoracoscopic surgery.Methods A total of 96 pa-tients who underwent elective thoracoscopic surgery were enrolledand randomly divided into group A(ropivacaine alone,with 30 mL of 5 g/L ropivacaine as the local anesthetic in SAPB),group B(0.25 mg/kg esketamine in addition to 5 g/L ropivacaine),and group C(0.50 mg/kg esketamine in addition to 5 g/L ropivacaine).Numerical Rating Scale(NRS)score was recorded at 2,6,12,24,and 48 hours after surgery,as well as the amount of morphine used at 48 hours after surgery,the time to the first pressing of patient-controlled intravenous analgesia(PCIA)device after surgery,the proportion of patients requiring PCI A after surgery,the amount of sufentanil used during surgery,and the incidence rate of adverse reactions.Results Compared with group A,group C had a significant reductionin NRS score at 12 and 24 hours after surgery(H=9.006,8.785,P＜0.05),a significant reduc-tion in the amount of morphine used at 48 hours after surgery(H=7.400,P＜0.05),and a significant prolongation of the time to the first pressing of PCIA(P＜0.05).There were no significant differences between the three groups in the proportion of patients requiring PCIA and the amount of sufentanil used during surgery(P＞0.05).There was also no significant difference in the inci-dence rate of adverse reactions between the three groups(P＞0.05).Conclusion Compared with ropivacaine alone,the combi-nation of 0.50 mg/kg esketamine and ropivacaine for SAPB in patients undergoing thoracoscopic surgery can enhance the postopera-tive analgesic effect,reduce the amount of morphine used at 48 hours after surgery,and prolong the duration of SAPB analgesia,with little adverse effect.关键词
氯胺酮/罗哌卡因/神经肌肉阻滞/胸外科手术,电视辅助/疼痛,手术后Key words
ketamine/ropivacaine/neuromuscular blockade/thoracic surgery,video-assisted/pain,postoperative分类
医药卫生引用本文复制引用
丁冰,寇清晏,王艳婷,王羽,李琳,牛泽军..不同剂量艾司氯胺酮联合罗哌卡因前锯肌平面阻滞对胸腔镜手术病人术后镇痛的影响[J].青岛大学学报（医学版）,2024,60(2):279-283,5.基金项目
青岛大学附属医院"临床医学+X"科研项目(QDFY+X202101057) （QDFY+X202101057）
