不同浓度罗哌卡因在椎间孔镜下腰椎间盘摘除术腰麻中的应用效果对比
DOI:
作者:
作者单位:

南阳市中心医院

作者简介:

通讯作者:

中图分类号:

基金项目:


Comparison of the effects of different concentrations of ropivacaine in the treatment of lumbar anesthesia under lumbar discectomy
Author:
Affiliation:

Nanyang Central Hospital

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:探讨不同浓度罗哌卡因在椎间孔镜下腰椎间盘摘除术腰麻中的应用效果。方法:选取腰椎间盘突出症(Lumbar disc herniation,LDH)患者128例,依据腰麻中罗哌卡因浓度不同分为A组(0.1%罗哌卡因,n= 40)、B组(0.15%罗哌卡因,n=46)、C组(0.2%罗哌卡因,n=42)。观察比较所有患者感觉神经阻滞情况、运动神经阻滞情况、术中疼痛程度情况、肌松效果及麻醉前、麻醉后30分钟、手术结束时BP、HR的变化情况。结果:(1)感觉神经阻滞起效时间及阻滞时间比较无明显差异;C组患者麻醉平面均高于其余两组,B组麻醉平面高于A组;C组麻醉持续时间明显高于其余两组,同时B组明显高于A组(P<0.05);(2)运动神经阻滞起效时间上C组患者明显短于其余两组,恢复时间上C组患者明显长于其余两组,同时B组长于A组(P<0.05);C组Bromage评分明显优于其余两组,同时B组优于A组(P<0.05);(3)C组疼痛程度明显优于其余两组,同时B组明显优于A组(P<0.05);C组肌松效果明显优于其余两组(P<0.05);(4)不同时间点HR变化均无明显差异;在麻醉30min时,C组BP明显低于其余两组(P<0.05);同时B、C组BP明显低于麻醉前(P<0.05)。结论:椎间孔镜下腰椎间盘摘除术腰麻最佳浓度为0.15%罗哌卡因,具有镇痛效果明显, 对运动神经阻滞轻, 对血流动力学影响小等优点。

    Abstract:

    Objective: To explore the effect of different concentrations of ropivacaine in lumbar discectomy under intervertebral foramen. Methods: 128 patients with lumbar disc herniation (LDH) were selected and divided into group A (0.1% ropivacaine, n = 40) and group B (0.15%) according to the different concentrations of ropivacaine in lumbar anesthesia Ropivacaine, n = 46), group C (0.2% ropivacaine, n = 42). Observe and compare the changes of sensory nerve block, motor nerve block, intraoperative pain level, muscle relaxation effect and the changes of BP and HR before and after anesthesia, 30 minutes after anesthesia at the end of surgery. Results: (1) There was no significant difference in the onset time and block time of sensory nerve block; the anesthesia level of patients in group C was higher than that of the other two groups, the anesthesia level of group B was higher than that of group A; the duration of anesthesia in group C was significantly higher The remaining two groups, while group B was significantly higher than group A (P <0.05); (2) Motor nerve block onset time was significantly shorter in group C patients than the remaining two groups, and recovery time in group C patients was significantly longer than the remaining two groups At the same time, group B is longer than group A (P <0.05); group C Bromage score is significantly better than the other two groups, and group B is better than group A (P <0.05); (3) group C is significantly better than the other two groups At the same time, group B was significantly better than group A (P <0.05); the muscle relaxation effect of group C was significantly better than the other two groups (P <0.05); (4) There was no significant difference in HR changes at different time points; at 30 minutes of anesthesia, BP in group C was significantly lower than that in the other two groups (P <0.05); meanwhile, BP in groups B and C was significantly lower than before anesthesia (P <0.05). Conclusion: The optimal concentration of lumbar anesthesia under lumbar discectomy under intervertebral foramen is 0.15% ropivacaine, which has the advantages of obvious analgesic effect, light motor nerve block and little effect on hemodynamics.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2020-04-22
  • 最后修改日期:2020-06-19
  • 录用日期:2020-06-28
  • 在线发布日期:
  • 出版日期: