罗哌卡因肋间神经根局部浸润麻醉下纤支镜胸膜腔活检术效果观察(1)
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【摘要】 目的探讨罗哌卡因肋间神经根局部浸润麻醉下行纤支镜胸膜腔活检术的效果。方法 观察43例罗哌卡因肋间神经根局部浸润麻醉下行纤支镜胸膜腔活检术的术中、术后镇痛效果。结果 43例手术均顺利完成,术中成功取得活检,有19例(44.2%)患者术中疼痛稍明显,但均能忍受,无剧烈疼痛者。术后有14例(32.6%)患者术区疼痛,主要发生在术后24 h内,其中有4例(9.3%)患者给予口服镇痛药,有1例(2.3%)给予肌注镇痛药。术后4 h、8 h、及24 h全组VAS评分分别为(2.01± 0.53)分、(1.68± 0.51)分和(1.05± 0.49)分。术后活检结果恶性病变23例,良性病变20例,在术后8 h、24 h良性病变组的VAS评分大于恶性病变组(P<0.05)。结论 在罗哌卡因局部浸润麻醉下,可以顺利完成经胸壁纤支镜胸膜腔活检术,术中及术后镇痛效果满意,无明显并发症。
【关键词】 罗哌卡因;局部浸润麻醉;纤支镜;胸膜腔活检术
Effect of intercostal nerve root infiltration anesthesia with ropivacaine in pleural biopsy by bronchoscopy
YU Tao,KAN Qi wei.
Department of Anesthesiology,Kaiyuan City people’s Hospital,Honghe 661600,China
【Abstract】 Objective To investigate the effect of intercostal nerve root infiltration anesthesia with ropivacaine in pleural biopsy by bronchoscopy.Methods Studied the analgesic effect intraoperatively and postoperatively in 43 cases received bronchoscopy pleural biopsy by intercostal nerve root infiltration anesthesia with ropivacaine.Results Operations of 43 cases were successful,and it was successful to obtain biopsy.No case feeled severe pain intraoperatively instead of 19 cases(44.2%) feeled a little pain that was tolerable.Fourteen cases feeled postoperative pain during the first 24 h mainly,in which there were 4 cases(9.3%) who needed oral analgesics and 1 case(2.3%) who needed intramuscular analgesics.The postoperative visual analogue scale(VAS) at 4 h,8 h and 24 h were (2.01± 0.53)、(1.68± 0.51)and(1.05± 0.49) respectively.There were 23 cases with m alignant lesions and 20 cases with benign lesions by postoperative pathology.The VAS of benign lesion group was higher than m alignant lesion group(P<0.05).Conclusion It is possible to complete transthoracic pleural cavity biopsy under bronchoscopy by local infiltration anesthesia with ropivacaine.Wiht satisfactory analgesia effect intraoperatively and postoperatively,there is no significant complications.
【Key words】 Ropivacaine; Local infiltration anesthesia; Bronchoscopy; Transthoracic pleural cavity biopsy
肋间神经根局部浸润麻醉下纤支镜胸膜腔活检术是一项简单而确诊率高的技术,配以罗哌卡因肋间神经局部浸润麻醉,此手术更是简化、节省费用 ......
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