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Clinical effect of intercostal nerve blocks using ropivacaine combined with flurbiprofen axeti |
YAO Yongzheng1, SHI Chunsheng2, ZHAO Cong3 |
1.Department of thoracic surgery,Miyun Hospital of Capital Medical University,Beijing 101500,China; 2.Department of anesthesiology,Miyun Hospital of Capital Medical University,Beijing 101500,China; 3.Department of Oncology Shougang Hospital of Peking University,Beijing 100144,China |
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Abstract Objective To evaluate the effect of intercostal nerve blocks using ropivacaine combined with flurbiprofen axetil for postoperative analgesia in patients following rib fracture fixation.Methods We retrospectively analyzed 80 patients with rib fracture, who underwent fixation between February 2014 and February 2016. The patients were randomly divided into two groups. Group A received intercostal nerve blocks using ropivacaine combined with intravenous flurbiprofen (40 cases) while Group B used analgesia pumps alone (40 cases). Postoperative pain scores, lung infections, adverse drug reactions and results of postoperative psychological assessment were compared between the two groups.Results Postoperative pain scores and incidence rates of pulmonary complications and adverse drug reactions (lethargy, nausea/vomiting, pruritus and respiratory depression) were significantly lower in Group A. The average scores of pain in the observation group were lower those in the control group (3,5,8,12 h) (P<0.05). Psychological burden scores in Group A were lower than in Group B, while resilience and optimism scores were higher in Group A. There were 2 cases of drowsiness, 3 cases of nausea, 1 case of vomiting, 1 case of skin pruritus, and 1 case of respiratory depression in the observation group, which was better than in the control group.Conclusions Intercostal nerve blocks using ropivacaine combined with flurbiprofen axetil can more effectively reduce postoperative pain, alleviate psychological burden and is worthy of clinical popularization.
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[1] |
Vledder,Hagenaars T,Verhofstad. The elderly patient with multiple rib fractures[J]. Ned Tijdschr Geneeskd,2015,159:9045.
|
[2] |
Unsworth A,Curtis K,Asha.Treatments for blunt chest trauma and their impact on patient outcomes and health service delivery. [J].Scand J Trauma Resusc Emerg Med,2015, 8(23):17.
|
[3] |
Marasco S,Lee G,Summerhayes R, et al .Quality of life after major trauma with multiple rib fractures[J]. Injury,2015,46(1):61-65.
|
[4] |
Kim Y J,Cho H M,Yoon C S, et al .Thoracic Epidural Anesthesia and Analgesia (TEA) in Patients with Rib Fractures[J]. Korean J Thorac Cardiovasc Surg,2011,44(2):178-182.
|
[5] |
Nonaka T, Hara M, Miyamoto C, et al .Comparison of the analgesic effect of intravenous acetaminophen with that of flurbiprofen axetil on post-breast surgery pain: a randomized controlled trial[J].J Anesth, 2016,30(3):405-409.
|
[6] |
Ho A M,Karmakar M K,Critchley L A, et al . Acute painmanagement of patients w ith multiple fractured ribs: a focus on regional techniques[J]. Curr Opin Crit Care,2011,17(4):323-327.
|
[7] |
Schnabel A,Reichl S U,Kranke P, et al . Effic acy and safety of paravertebral blocks in breast surgery: a meta-a-nalysis of randomized controlled trials[J]. Br J Anaesth,2010,105( 6) : 842-852.
|
[8] |
孙立新,丛 丽,王明山,等.双侧胸椎旁神经阻滞术后镇痛在非体外循环冠脉搭桥术患者中的应用[J].中华医学杂志,2013,93(45):3569-3572.
|
[9] |
王 莉,宁 杰,李艳华,等.术侧胸椎旁阻滞对单肺通气期间肺内分流及氧合的影响[J].临床麻醉学杂志,2013,29(6):564-566.
|
[10] |
周时蓓,仓 静.肋间神经阻滞联合静脉自控镇痛对胸腔镜手术患者术后镇痛效果的观察[J].中国临床医学,2011,18(2):226-229.
|
[11] |
李冬梅,陈兰兰,韩玉婷,等.综合干预措施对脑卒中康复陪护者的心理影响[J].武警医学,2016, 27(10) : 1063-1066.
|
[12] |
杜 丽, 唐育民.曲马多联合罗哌卡因行肋间神经阻滞用于肺癌患者术后镇痛的临床研究[J].东南大学学报(医学版),2015,2(6):235-239.
|
[13] |
余 涛,阚奇伟.罗哌卡因肋间神经根局部浸润麻醉行胸腔镜良性肺结节切除术疗效观察[J].现代医药卫生,2010,24(9):3703-3704.
|
[14] |
肖敬波,王胜斌,徐四七,等.罗哌卡因肋间神经阻滞用于胸科术后镇痛的临床观察[J].临床医学,2010,30(12):14-16.
|
[15] |
Fujita Y, Hasegawa S, Kato Y, et al .Intravenous injection of low-dose flurbiprofen axetil for preventing post-ERCP pancreatitis in high-risk patients: An interim analysis of the trial[J].Endosc Int Open, 2016,4(10):1078-1082.
|
[16] |
Nonaka T, Hara M, Miyamoto C, et al . Comparison of the analgesic effect of intravenous acetaminophen with that of flurbiprofen axetil on post-breast surgery pain: a randomized controlled trial[J]. J Anesth,2016,30(3):405-409.
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