| 张代玲,冯树全,邵安民.喷他佐辛复合罗哌卡因臂丛阻滞对全麻下肩关节镜手术围术期应激反应和术后疼痛的影响[J].安徽医药,2018,22(11):2241-2243. |
| 喷他佐辛复合罗哌卡因臂丛阻滞对全麻下肩关节镜手术围术期应激反应和术后疼痛的影响 |
| Effect of pentazocin combined with ropivacaine for brachial plexus block on the perioperative stress response and postoperative pain of arthroscopic shoulder surgery patients undergoing general anesthesia |
| 投稿时间：2017-06-20 |
| DOI： |
| 中文关键词: 喷他佐辛 臂丛阻滞 肩关节镜 应激反应 |
| 英文关键词: Pentazocin Brachial plexus block Shoulder arthroscopy Stress response |
| 基金项目:昆山市社会发展科技专项项目(KS1556) |
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| 中文摘要: |
| 目的 探讨喷他佐辛复合罗哌卡因臂丛神经阻滞对全麻下肩关节镜手术患者围术期应激反应和术后疼痛的影响。方法 选取昆山市中医医院2015年7月至2017年2月择期行肩关节镜手术的患者60例,采用随机数字表法分为三组:全身麻醉组(GA组),罗哌卡因臂丛阻滞+全身麻醉组(LG组)、喷他佐辛复合罗哌卡因臂丛阻滞+全身麻醉组(PG组),每组20例。监测并记录三组患者入室时(T0),手术开始后30 min(T1),术毕(T2),术后6 h(T3)、术后12 h(T4)及术后24 h(T5)的血清去甲肾上腺素(NE)、肾上腺素(E)、促肾上腺皮质激素(ACTH)和皮质醇(Cor)水平；观察并记录三组患者T3～T5时的视觉模拟评分法(VAS) 评分。结果 与LG组相比,PG组T4～5时VAS评分明显降低(P<0.05),GA组T3～4VAS评分明显升高(P<0.05);与T0相比,GA组T2～4时的NE和Cor明显升高(P<0.05),且T3～4时的E、ACTH明显升高(P<0.05)；LG组T3～4时的NE、E、ACTH和Cor明显升高(P<0.05)；PG组T4时NE、E、ACTH和Cor明显升高(P<0.05)；与LG组相比,GA组T2～4时的NE和Cor明显升高(P<0.05),且T3～4时的E、ACTH明显升高(P<0.05)；PG组血清NE、E、ACTH和Cor在T3～4时明显降低(P<0.05)。结论 喷他佐辛复合罗哌卡因臂丛阻滞可明显减轻全麻下肩关节镜手术患者围术期应激反应和术后疼痛。 |
| 英文摘要: |
| Objective To explore the effect of pentazocin combined with ropivacaine for brachial plexus block on the perioperative stress response and postoperative pain of arthroscopic shoulder surgery patients undergoing general anesthesia.Methods In a double-blind study,60 patients undergoing arthroscopic shoulder surgery in the Traditional Chinese Medicine Hospital of Kunshan from July 2015 to February 2017 were randomized into 3 groups (n=20 each):general anesthesia group (group GA),ropivacaine for brachial plexus block and general anesthesia (group LG) and pentazocin combined with ropivacaine for brachial plexus block and general anesthesia (group PG).The levels of noradrenaline (NE),epinephrine (E),adrenocorticotropic hormone (ACTH) and cortisol (Cor) of all patients were monitored and recorded before the anesthesia (T0),30 minutes after operation (T1),immediately after operation (T2),6 h after operation (T3),12 h after operation (T4) and 24 h after operation (T5).Visual analogue scale (VAS) scores were determined and recorded from T3 to T5.Results Compared with group LG,VAS score of group PG was decreased from T4 to T5 (P<0.05),and increased from T3 to T4 (P<0.05).Compared with T0,the levels of NE and Cor in group GA were increased significantly from T2 to T4 (P<0.05),and the levels of Eand ACTH were increased significantly from T3 to T4 (P<0.05).Except that,the levels of NE,E,ACTH and Cor in group LG were increased significantly from T3 to T4 (P<0.05),and the levels of NE,E,ACTH and Cor in group PG were increased significantly in T4 (P<0.05).Compared with group LG,the levels of NE and Cor in group GA were increased significantly from T2 to T4 (P<0.05),and the levels of Eand ACTH were increased significantly from T3 to T4 (P<0.05).The levels of NE,E,ACTH and Cor in group PG were decreased significantly from T3 to T4 (P<0.05).Conclusion Pentazocin combined with ropivacaine for brachial plexus block can effectively alleviate the perioperative stress response and postoperative pain of arthroscopic shoulder surgery patients undergoing general anesthesia. |
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