Preoperative ropivacaine infiltration in breast surgery
Preoperative ropivacaine infiltration in breast surgery
复制标题
DOI：
10.1034/j.1399-6576.2000.440910.x
复制
发表时间：
2000-10-01
影响因子：
2.1
通讯作者：
Lundberg, J
中科院分区：
文献类型：
--
作者：
Johansson, A;Axelson, J;Lundberg, J
目的：本研究的目的是探讨术前罗哌卡因浸润配合乳房手术是否能改善术后疼痛管理和减轻术后恶心呕吐。方法：前瞻性、随机、双盲研究，将60名健康女性（ASA 1-2）分为两组。30例患者术前在术野给予0.3 ml/kg生理盐水。另外30名患者接受了类似体积的3.75 mg/ml罗哌卡因。采用视觉模拟量表（0 ~ 100 mm）评价术后疼痛、恶心、呕吐情况。静息时评分大于30mm者，给予酮贝米酮静脉治疗术后疼痛，二嗪静脉治疗恶心呕吐。记录术中及术后镇痛需求及术后恶心呕吐情况。结果：生理盐水组术中芬太尼用量（81 +/- 22 mu g）与（76 +/- 28 mu g）相似；（ns）在罗哌卡因组。术后24小时酮贝酮消耗量也与罗哌卡因组相似（4.2 +/- 2.6 mg vs 4.2 +/- 4.3 mg; ns）。两组术后恶心呕吐发生率相似。两组24小时的二嗪消耗量相同（生理盐水组2.1 +/- 2.7 mg，罗哌卡因组2.4 +/- 2.8 mg; ns）。恢复6小时后，41%的患者出现恶心，20%出现呕吐。结论：3.75 mg/ml罗哌卡因与乳房手术前伤口浸润盐水对术后疼痛的处理无差异。数据显示，术后镇痛药和止吐药的需求相似，PONV发生率相似。
Purpose: The aim of the study was to investigate whether preoperative infiltration with ropivacaine in conjunction with breast surgery improves postoperative pain management and attenuates postoperative nausea and vomiting.Method: Prospective, randomised, double-blind study, including 60 healthy women (ASA 1-2) allocated to one of two groups. Thirty patients were given 0.3 ml/kg saline in the operating field before surgery. Another 30 patients received a similar volume of ropivacaine 3.75 mg/ml. A visual analogue scale (0-100 mm) was used for evaluation of postoperative pain, nausea and vomiting. If the score was more than 30 mm at rest, the patients were given ketobemidone i.v. as treatment for postoperative pain, and dixyrazine i.v. against nausea and vomiting. The intra- and postoperative analgesic requirements and postoperative nausea and vomiting were registered.Results: The intraoperative fentanyl consumption was similar in the saline group 81 +/- 22 mu g vs 76 +/- 28 mu g; (ns) in the ropivacaine group. The postoperative 24-h ketobemidone consumption was also similar to those treated with ropivacaine (4.2 +/- 2.6 mg vs 4.2 +/- 4.3 mg; ns). Postoperative nausea and vomiting (PONV) occurred with similar frequencies in both groups. The 24-h dixyrazine consumption was the same in the two groups (2.1 +/- 2.7 mg in the saline group compared to 2.4 +/- 2.8 mg in the ropivacaine group; ns). After 6 h recovery, 41% of all patients had experienced nausea and 20% vomiting.Conclusion: We found no differences in postoperative pain management between 3.75 mg/ml ropivacaine and saline wound infiltration before breast surgery. The data show similar postoperative needs of analgesics and antiemetics with a similar frequency of PONV.