罗哌卡因复合地塞米松胸椎旁神经阻滞用于胸腔镜肺癌患者根治术的临床研究OA北大核心CSTPCD
Clinical trial of thoracic paravertebral nerve block with ropivacaine and dexamethasone in the treatment of patients undergoing thoracoscopic radical resection of lung cancer
目的 分析罗哌卡因复合地塞米松胸椎旁神经阻滞(TPVB)对胸腔镜肺癌根治术患者麻醉质量及术后疼痛的影响.方法 将行全麻胸腔镜手术的肺癌患者按队列法分为对照组和试验组.对照组用0.5％罗哌卡因注射液15 mL进行TPVB,试验组用0.5％罗哌卡因注射液15 mL联合0.15 mg·kg-1地塞米松注射液进行TPVB.比较2组患者的TPVB麻醉效果(包括TPVB起效时间、持续时间及术后48 h内镇痛泵有效按压次数)、平均动脉压(MAP)和心率(HR)、术后安静和咳嗽时视觉模拟评分(VAS)、40项术后恢复质量调查问卷(QoR-40)评分,并进行安全性评价.结果 试验组和对照组分别纳入48和52例.对照组和试验组TPVB起效时间分别为(10.86±1.93)和(7.21±1.15)min,TPVB持续时间分别为(400.27±33.15)和(859.73±50.69)min,镇痛泵有效按压次数分别为(13.42±3.70)和(7.18±1.94)次,术后24 h安静时VAS评分分别为(2.45±0.48)和(2.08±0.35)分,术后24 h咳嗽时VAS评分分别为(3.85±0.44)和(3.59±0.39)分,术后3 d时的QoR-40评分分别为(152.97±9.49)和(175.30±6.14)分,试验组上述指标与对照组比较,在统计学上差异均有统计学意义(均P＜0.05);2组患者T0～T3时间点的MAP和HR比较,在统计学上差异均无统计学意义(均P＞0.05).试验组和对照组的总药物不良反应发生率分别为10.42％(5例/48例)和11.54％(6例/52例),在统计学上差异无统计学意义(P＞0.05).结论 罗哌卡因复合地塞米松用于TPVB能够明显改善全麻下肺癌胸腔镜手术患者麻醉质量,减轻术后疼痛,促进患者术后恢复,安全性较高.
Objective To analyze the effects of thoracic paravertebral block(TPVB)with ropivacaine and dexamethasone on anesthesia quality and postoperative pain in patients undergoing thoracoscopic radical resection of lung cancer.Methods Patients with lung cancer who underwent thoracoscopic surgery under general anesthesia were divided into control group and treatment group by cohort method.Control group received 15 mL of 0.5％ropivacaine injection for TPVB;and treatment group was given 15 mL of 0.5％ropivacaine injection combined with 0.15 mg·kg-1 dexamethasone injection for TPVB.The TPVB effect(TPVB onset time,duration,the number of effective analgesic pump compressions with in 48 hours after surgery),mean arterial pressure(MAP),heart rate(HR),visual analogue scale(VAS)scores at rest and coughing after surgery,quality of recovery-40 questionnaire(QoR-40)score and occurrence of adverse drug reactions were compared between the two groups.Results There were 48 patients in treatment group and 52 patients in control group.The TPVB onset times in control group and treatment group were(10.86±1.93)and(7.21±1.15)min;the durations of TPVB were(400.27±33.15)and(859.73±50.69)min;the number of effective analgesic pump compressions were(13.42±3.70)and(7.18±1.94)times;the VAS scores at rest at 24 hours after surgery were(2.45±0.48)and(2.08±0.35)points;the VAS scores at coughing at 24 hours after surgery were(3.85±0.44)and(3.59±0.39)points,the QoR-40 scores at 3 days after surgery were(152.97±9.49)and(175.30±6.14)points.There were statistically significant differences in the above indexes between the treatment group and the control group(all P＜0.05).There were no statistically significant differences in MAP and HR at T0-T3 between the two groups(all P＞0.05).The total incidence rates of adverse drug reactions in treatment group and control group were 10.42％(5 cases/48 cases)and 11.54％(6 cases/52 cases),respectively(P＞0.05).Conclusion Ropivacaine combined with dexamethasone for TPVB can significantly improve the anesthesia quality,relieve the postoperative pain and promote the postoperative recovery in patients undergoing thoracoscopic surgery for lung cancer under general anesthesia,and it has high safety.
陈曲敏;蔡东妙
厦门大学附属第一医院麻醉手术室,福建厦门 361003
药学
罗哌卡因注射液地塞米松注射液胸椎旁神经阻滞肺癌胸腔镜麻醉质量术后疼痛
ropivacaine injectiondexamethasone injectionthoracic paravertebral blocklung cancerthoracoscopeanesthesia qualitypostoperative pain
《中国临床药理学杂志》 2024 (020)
2954-2957 / 4
评论