作　　者： (肖泽田）; (黎丹萍）; (周兵）; (彭洪）;

机构地区： 江西省萍乡市人民医院麻醉科,江西萍乡337000

出　　处： 《上海医药》 2017年第17期25-26,37,共3页

摘　　要： 目的:探讨罗哌卡因联合奥布卡因对全麻鼻内镜术中的麻醉控制效果及术中应激反应的影响。方法:选择80例行鼻内镜术治疗患者随机为观察组和对照组各40例。对照组局部使用肾上腺素加用利多卡因局部浸润联合丁卡因表面麻醉,观察组局部使用肾上腺素加用罗哌卡因局部浸润联合奥布卡因表面麻醉;比较术后苏醒时间以及不同时刻的视觉疼痛模拟评分(VAS)及术中应激反应;检测术前及术中的血糖和去甲肾上腺素水平。结果:观察组术后苏醒时间显著短于对照组;苏醒即刻时两组VAS评分差异不显著,其余各时刻观察组VAS评分均显著低于对照组;两组术中血糖水平均较术前显著上升但观察组术中血糖显著低于对照组,对照组术中去甲肾上腺素水平显著上升且显著高于观察组(P<0.05)。结论:观察组的麻醉方法有助于增加麻醉可控性和安全性,减轻患者术中应激反应及术后疼痛。 Objective： To investigate the effect of ropivacaine combined with benoxinate on general anesthesia during sinus endoscopic surgery and the control of intraoperative stress reaction. Methods： Eighty patients underwent endoscopic sinus surgery were randomly divided into an observation group and a control group with 40 cases each. The control group was anesthetized by local epinephrine with lidocaine local infiltration and tetracaine anesthesia and the observation group by local epinephrine infiltration of ropivacaine combined benoxinate surface anesthesia. The postoperative recovery time, visual analogue scores （VAS） at different times and intraoperative stress reaction were compared. The preoperative and intraoperative levels of both blood glucose and norepinephrine were detected. Results： The postoperative recovery time was significantly shorter in the observation group than in the control group. There were no significant differences in VAS at immediate recovery between the two groups. The VAS at the rest of the time were significantly lower in the observation group than in the control group. The blood glucose levels were significantly higher during operation than before surgery, but lower in the observation group than in the control group. The intraoperative noradrenaline level in the control group was significantly increased and furthermore significantly higher than in the observation group （P〈0.05）. Conclusion： The anesthetic method for the observation group is helpful in improving the controllability and safety of anesthesia and reducing the stress reaction in patients with postoperative pain.

关 键 词： 罗哌卡因 奥布卡因 鼻内镜 术中应激