【摘要】 目的:探讨经硬膜外腔注入0.2%罗哌卡因在全麻下急性阑尾炎手术中的效果。方法:选取2016年8月～2018年5月在我院治疗的急性阑尾炎患者96例,采用随机数字表法将患者随机分为观察组(n=49)和对照组(n=47),观察组给予硬膜外腔注入0.2%罗哌卡因,对照组给予静脉注射芬太尼,观察麻醉诱导前(TO)、切皮时(T1)、术中探查时(T2)及手术结束时(T3)的心率(HR)、收缩压(SBP)及舒张压(DBP)、术后24h触痛阈和机械痛觉过敏范围、皮质醇及血糖水平。结果:观察组T2、T3时SBP和DBP明显低于对照组;观察组术后触痛阈为(62.10±14.22)g/mm~2,明显高于对照组,而机械痛觉过敏范围为(3.28±0.82)cm,明显低于对照组;观察组术后血糖及皮质醇分别为(5.56±0.72)mmol/L和(503.27±101.31)mmol/L,明显低于对照组。结论:经硬膜外腔注入低浓度罗哌卡因用于急性阑尾炎手术有较好的应用价值,能减轻患者术后痛觉过敏范围及程度,抑制应激反应。更多还原

【Abstract】 Objective To investigate the effect of epidural injection of 0.2% ropivacaine in acute appendicitis surgery under general anesthesia.Methods 96 patients with acute appendicitis treated in our hospital from August 2016 to May 2018 were randomly divided into the observation group (n=49) and the control group (n=47) by random digital table method,0.2% ropivacaine was injected into the epidural space in the observation group,and the control group was given intravenous fentanyl,the heart rate (HR),systolic pressure (SBP) and diastolic pressure (DBP) at before induction of anesthesia (TO),skin cutting (T1),intraoperative exploration (T2) and the end of operation (T3),touch pain threshold and mechanical pain sensitivity range at 24h after operation,cortisol and blood glucose level were observed.Results SBP and DBP in the observation group at T2 and T3 were significantly lower than those in the control group;The pain threshold of the observation group was (62.10±14.22) g/mm~2,which was significantly higher than that of the control group,while the range of mechanical pain sensitivity was (3.28±0.82) cm,which was significantly lower than that of the control group;Postoperative blood glucose and cortisol in the observation group were (5.56±0.72) mmol/L and (503.27±101.31) mmol/L,were significantly lower than those in the control group.Conclusion Intradural injection of low concentration ropivacaine for acute appendicitis is of good application value,can reduce the extent and degree of postoperative hyperalgesia and inhibit the stress response.更多还原