Department of Anesthesiology, Pangang Group General Hospital, Panzhihua, Sichuan, China.
Department of Anesthesiology, Fengdu People's Hospital, No. 33, Lutang Street, Sanhe Street, 408200, Fengdu County, Chongqing, China.
BMC Anesthesiol. 2022 Feb 26;22(1):54. doi: 10.1186/s12871-022-01595-8.
To explore the analgesic effects of different concentrations of ropivacaine in transversalis fascia plane (TFP) block during laparotomy.
Ninety patients who underwent laparotomy admitted to our hospital from March 2019 to March 2020 were selected as the study subjects and were divided equally into a low concentration group, a medium concentration group, and a high concentration group according to the randomized grouping method. The low concentration group adopted 0.4% ropivacaine 40 ml, the medium concentration group was given 0.5% ropivacaine 40 ml, and the high concentration group was given 0.6% ropivacaine 40 ml. The hemodynamic indexes and the incidence of adverse reactions in the two groups were compared. The Numerical Rating Scale (NRS) was used to assess the postoperative pain in the three groups, the Bruggrmann comfort scale (BCS) was used to assess the comfort level in the three groups, and the Mini-mental State Examination (MMSE) was used to evaluate the postoperative cognitive function of the three groups of patients.
The mean artery pressure (MAP) and heart rate (HR) levels at T1 and T2 were significantly lower in the medium concentration group than in the other two groups (P < 0.05). The low concentration group had a significantly higher NRS score at T2 than the medium concentration group and the high concentration group (P < 0.05). A significantly higher BCS score was observed in the high concentration group than the other two groups (P < 0.05). There were significantly higher Ramsay scores and MMSE scores in the medium concentration group than in the low concentration and high concentration groups (P < 0.05). The overall incidence of adverse reactions of the high concentration group was significantly higher than that of the low concentration group (P < 0.05), but showed similar results with the medium concentration group.
The medium concentration group exhibits a better analgesic effect than the low concentration group and higher safety than the high concentration group. Therefore, the use of medium concentration ropivacaine in TFP block may provide a referential basis for clinical treatment.
探讨腹横筋膜平面（TFP）阻滞中不同浓度罗哌卡因的镇痛效果。
选择 2019 年 3 月至 2020 年 3 月我院收治的 90 例行剖腹手术患者为研究对象，按随机分组法分为低浓度组、中浓度组和高浓度组，每组 30 例。低浓度组采用 0.4%罗哌卡因 40ml，中浓度组给予 0.5%罗哌卡因 40ml，高浓度组给予 0.6%罗哌卡因 40ml。比较两组患者的血流动力学指标和不良反应发生率。采用数字评分法（NRS）评估三组患者术后疼痛情况，采用布鲁格曼舒适度评分（BCS）评估三组患者舒适度，采用简易精神状态检查量表（MMSE）评估三组患者术后认知功能。
中浓度组 T1、T2 时平均动脉压（MAP）和心率（HR）水平明显低于其他两组（P<0.05）。低浓度组 T2 时 NRS 评分明显高于中浓度组和高浓度组（P<0.05）。高浓度组 BCS 评分明显高于其他两组（P<0.05）。中浓度组 Ramsay 评分和 MMSE 评分明显高于低浓度组和高浓度组（P<0.05）。高浓度组不良反应总发生率明显高于低浓度组（P<0.05），但与中浓度组比较差异无统计学意义。
中浓度组镇痛效果优于低浓度组，安全性高于高浓度组，因此，TFP 阻滞中应用中浓度罗哌卡因可能为临床治疗提供参考依据。
