目的:研究罗哌卡因联合地塞米松局部浸润对小儿扁桃体切除术后疼痛程度及炎症应激反应的影响.方法:选择在绵阳市中心医院接受择期扁桃体切除术的84例患儿作为研究对象,随机分为两组,联合组患儿罗哌卡因联合地塞米松局部浸润麻醉,对照组患儿接受罗哌卡因局部浸润麻醉.手术后6、12、24h时,检测血清中疼痛介质、炎症介质及应激介质.结果:手术后6h,两组患儿血清中β-EP、SP、BK、TNF-α、MCP-1、IL-4、IL-10、F-Cor、NE、AT-II、GH的含量无显著性差异;手术后12、24h,对照组患儿血清中β-EP、SP、BK的含量较手术后6h时显著升高,联合组患儿血清中β-EP、SP、BK的含量与手术后6h时比较无显著性差异,两组血清中TNF-α、MCP-1、IL-4、IL-10、F-Cor、NE、AT-II、GH的含量较手术后6h时显著升高且联合组患儿血清中TNF-α、MCP-1、IL-4、IL-10、F-Cor、NE、AT-II、GH的含量低于对照组.结论:罗哌卡因联合地塞米松局部浸润减轻小儿扁桃体切除术后疼痛程度及炎症应激反应的作用较单用罗哌卡因局部浸润更为持久且确切.%Objective:To study the effect of ropivacaine combined with dexamethasone local infiltration on the pain level and inflammatory stress response after pediatric tonsillectomy.Methods:A total of 84 children who received selective tonsillec-tomy in Mianyang Central Hospital were selected as the research subjects,and patients were randomly divided into combined group and control group,combined group received ropivacaine combined with dexamethasone local infiltration,and control group received ropivacaine local infiltration anesthesia.Serum levels of pain mediators,inflammatory mediators and stress me-diators were detected 6 h,12 h and 24 h after surgery.Results:Six hours after surgery,serumβ-EP,SP,BK,TNF-α,MCP-1,IL-4,IL-10,F-Cor,NE,AT-II and GH levels were not significantly different between the two groups;12 h and 24 h after surgery,serum β-EP,SP,BK levels of control group were significantly higher than those 6 h after surgery,serum β-EP, SP,BK levels of combined group were not significantly different from those 6 h after surgery.Serum TNF-α,MCP-1,IL-4, IL-10,F-Cor,NE,AT-II and GH levels of two groups were significantly higher than those 6 h after surgery,and Serum TNF-α,MCP-1,IL-4,IL-10,F-Cor,NE,AT-II and GH levels of combined group were significantly lower than those of control group.Conclusion:Ropivacaine combined with dexamethasone local infiltration is more durable and exact than ropivacaine local infiltration alone in relieving the pain and inflammatory stress response after pediatric tonsillectomy.
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