目的：对比研究低浓度罗哌卡因、布比卡因、利多卡因在烧伤手术患者头部取皮后的镇痛效果。方法84例烧伤后切削痂植皮的患者采用头部取皮法，随机分为4组( n=21)，其中常规对照组( C组)按既往常规方法在头皮下注入含1/200000的肾上腺素生理盐水200 mL进行头皮下扩张，罗哌卡因组(R组)0.05%罗哌卡因200 mL进行头皮下局麻并扩张头皮，布比卡因组(B组)0.188%布比卡因头皮下局麻，利多卡因组(L组)0.1%利多卡因头皮下局麻；分别于麻醉开始前(T0)、手术结束患者清醒后20 min(T1)、5 h(T2)和10 h(T3)时采用肌肉活动评分法(MAAS)进行意识状态评价，并采用视觉模糊评分(VAS)对头部及躯体创面分别进行疼痛评估，全程监测心率、血压等生命体征进行安全性评价。结果4组患者均安全度过围手术麻醉期，其中R组患者在3个时间点VAS评分均明显低于其余3组。结论头皮下低浓度罗哌卡因注射更适合应用于患者头皮取皮后的镇痛。%Objective To investigate the different effect among ropivacaine,bupivacaine,lidocaine on analgesia after harvesting grafts from the scalp in burn patients. Methods 84 patients who need harvesting grafts from the scalp after burn were divided in 4 groups random-ly(n=21). Patients in group C hypodermically injected with saline 200 mL were control,while patients in group R injected with 0. 05% ropi-vacaine 200 mL,group B with 0. 188% bupivacaine,and group L with 0. 1% lidocaine. Motor activity assessment scale( MAAS) and visual analogue scale(VAS) were made before anesthesia(T0) and 20 min,5 h,10 h after awake of patients. VAS were made focus on head and body in part. Vital signs were also monitored and recorded for assessment of security. Results All patients in 4 groups had passed the period of operation safely. Patients in group R have better VAS than other groups. Conclusion Low concentration ropivacaine hypodermically injec-tion of head is helpful to relieve the pain after harvesting grafts from the scalp.
展开▼
