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目的采用罗哌卡因局部麻醉用于婴儿唇裂修补手术,观察其术后镇痛效果。方法麻醉组由手术医生给予0.3%罗哌卡因+肾上腺素盐水(1∶400 000)1~2 m L手术部位局部注射,对照组用肾上腺素盐水(1∶400 000)。5 min后开始手术,术中调节七氟醚浓度调整麻醉深度。观察患儿拔管1 h后、2 h后、4 h后和6 h后的镇痛效果,同时观察患儿术后躁动、呼吸抑制及恶心呕吐例数。结果拔管2 h后、4 h后、6 h后,麻醉组NIPS评分明显低于对照组。拔管后呼吸抑制例数、恶心呕吐例数两组未见明显差异,术后对照组躁动例数明显多于麻醉组。结论罗哌卡因局部麻醉用于婴儿唇裂修补手术中,使用方便安全,术后镇痛效果佳,临床上值得推广。
Objective To use ropivacaine local anesthesia for infant cleft lip repair surgery and observe its postoperative analgesic effect. Methods The anesthesia group was injected locally with 1 ~ 2 m L 0.3% ropivacaine plus epinephrine saline (1: 400 000), and the control group with epinephrine saline (1: 400 000). After 5 minutes, the operation was started. The concentration of sevoflurane was adjusted intraoperatively to adjust the depth of anesthesia. Observe the analgesic effect of 1 h, 2 h, 4 h and 6 h after extubation in children, and observe the number of postoperative agitation, respiratory depression and nausea and vomiting. Results After 2 hours of extubation, the NIPS scores of the anesthesia group were significantly lower than those of the control group after 4 hours and 6 hours after the extubation. After extubation, the number of respiratory depression, nausea and vomiting cases no significant difference between the two groups, postoperative control group more agitation than the anesthesia group. Conclusion Local anesthesia of ropivacaine is used in the repair of cleft lip in infants. It is convenient and safe to use and has good analgesic effect after operation. It is worth to be popularized clinically.