Cai H-D, Lin C-Z, Yu C-X, Lin X-Z
Department of Anaesthesiology, First Affiliated Hospital of Fujian Medical University, and Department of Pharmacology, Fujian Medical University, Fujian, China.
J Int Med Res. 2012;40(4):1390-8. doi: 10.1177/147323001204000417.
To compare the incidence of postoperative nausea and vomiting (PONV) and postoperative pain in thyroidectomy patients undergoing general anaesthesia, with or without bilateral superficial cervical plexus block (BSCPB).
In this prospective, randomized, double-blind study, adult patients scheduled for thyroid surgery under general anaesthesia were randomized to receive BSCPB with 20 ml 0.5% ropivacaine (ropivacaine group) or placebo (20 ml saline; saline group) before surgery. The incidence of PONV and postoperative pain, and the need for rescue antiemetics were assessed at 0-24 h postoperatively.
Data from 135 patients were evaluated and the incidence of PONV, the need for rescue antiemetics and the number of patients needing additional perioperative pain relief in the postanaesthetic care unit were significantly lower in the ropivacaine group compared with the saline group. Early postoperative (0-8 h) visual analogue scale pain scores were significantly lower in the ropivacaine group compared with the saline group.
BSCPB with 0.5% ropivacaine administered before surgery can significantly reduce the incidence of PONV and early postoperative pain and also reduce perioperative opioid requirements in thyroidectomy patients undergoing general anaesthesia.
比较全身麻醉下甲状腺切除术患者,行或不行双侧颈浅丛阻滞(BSCPB)时术后恶心呕吐(PONV)的发生率及术后疼痛情况。
在这项前瞻性、随机、双盲研究中,计划在全身麻醉下进行甲状腺手术的成年患者,在手术前被随机分为两组,一组接受20毫升0.5%罗哌卡因的双侧颈浅丛阻滞(罗哌卡因组),另一组接受安慰剂(20毫升生理盐水;生理盐水组)。在术后0至24小时评估PONV的发生率、术后疼痛情况以及使用急救止吐药的必要性。
对135例患者的数据进行了评估,结果显示,与生理盐水组相比,罗哌卡因组的PONV发生率、使用急救止吐药的必要性以及在麻醉后护理单元需要额外围手术期镇痛的患者数量均显著降低。与生理盐水组相比,罗哌卡因组术后早期(0至8小时)视觉模拟量表疼痛评分显著更低。
术前给予0.5%罗哌卡因进行双侧颈浅丛阻滞,可显著降低全身麻醉下甲状腺切除术患者的PONV发生率和术后早期疼痛,并减少围手术期阿片类药物的用量。