【罂粟摘要】不同浓度的罗哌卡因横筋膜平面阻滞在开腹手术中的镇痛效果

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不同浓度的罗哌卡因横筋膜平面阻滞在开腹手术中的镇痛效果

贵州医科大学麻醉与心脏电生理课题组  

翻译：张中伟 编辑：陈锐 审校：曹莹

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背景

探讨不同浓度罗哌卡因在剖腹手术横筋膜平面(TFP)阻滞中的镇痛效果。

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方法

中浓度组T1、T2时平均动脉压(MAP)、心率(HR)明显低于其他两组(P<0.05)。低浓度组T2时NRS评分明显高于中浓度组和高浓度组(P<0.05)。高浓度组BCS评分明显高于其他两组(P<0.05)。中浓度组Ramsay评分和MMSE评分明显高于低浓度组和高浓度组(P<0.05)。高浓度组总不良反应发生率明显高于低浓度组(P<0.05)，与中浓度组差异无显著性(P>0.05)。

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结果

中浓度组镇痛效果优于低浓度组，安全性高于高浓度组。因此，中浓度罗哌卡因在TFP阻滞中的应用可为临床治疗提供参考依据。

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结论

异丙酚相比，围手术期输注右美托咪定可改善接受冠状动脉搭桥术的患者的理想预后。

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原始文献来源

Ye Tian, Yong Zhan, Ke Liu, et al. Analgesic efects of diferent concentrations of ropivacaine in transversalis fascia plane block during laparotomy[J]. BMC Anesthesiology (2022) 22:54  

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Analgesic effects of different concentrations

of ropivacaine in transversalis fascia plane block

during laparotomy

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Abstract

Background:To explore the analgesic effects of different concentrations of ropivacaine in transversalis fascia plane (TFP) block during laparotomy.

Methods: Ninety patients who underwent laparotomy admitted to our hospital from March 2019 to March 2020 were selected as the study subjects and were divided equally into a low concentration group, a medium concentration group, and a high concentration group according to the randomized grouping method. The low concentration group adopted 0.4% ropivacaine 40 ml, the medium concentration group was given 0.5% ropivacaine 40 ml, and the high concentration group was given 0.6% ropivacaine 40 ml. The hemodynamic indexes and the incidence of adverse reactions in the two groups were compared. The Numerical Rating Scale (NRS) was used to assess the postoperative pain in the three groups, the Bruggrmann comfort scale (BCS) was used to assess the comfort level in the three groups, and the Mini-mental State Examination (MMSE) was used to evaluate the postoperative cognitive function of the three groups of patients.

Results: The mean artery pressure (MAP) and heart rate (HR) levels at T1 and T2 were significantly lower in the medium concentration group than in the other two groups (P < 0.05). The low concentration group had a significantly higher NRS score at T2 than the medium concentration group and the high concentration group (P < 0.05). A significantly higher BCS score was observed in the high concentration group than the other two groups (P < 0.05). There were significantly higher Ramsay scores and MMSE scores in the medium concentration group than in the low concentration and high concentration groups (P < 0.05). The overall incidence of adverse reactions of the high concentration group was significantly higher than that of the low concentration group (P < 0.05), but showed similar results with the medium concentration group.

Conclusions: The medium concentration group exhibits a better analgesic effect than the low concentration group and higher safety than the high concentration group. Therefore, the use of medium concentration ropivacaine in TFP block may provide a referential basis for clinical treatment.

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