Analgesia Effect Observation Of Intercostal Nerve Block With Pentazocine And Ropivacaine

Objective : This study aims to observe single intercostals nerve block with pentazocine and ropivacaine,whether can reduce postoperative pain score,prolong the duration of analgesia,enhance postoperative analgesia effect,lower the occurrence of side effects,and postpone the usage of analgesics.Methods: choose sixty patients received video-assisted thoracoscopic lobectomy surgery,which undergoing general anesthesia.ASA grade ?-?level,age 25~75 years old,BMI 20~25kg/m2,all patients had no severe hypertension,heart disease,diabetes mellitus.All patients also had no history of allergy of ropivacaine and other drugs,no history of hematological disease,chronic pain.Grouped settings(n=20each):ropivacaine(group R),pentazocine(group P)and pentazocine combined with ropivacaine(group P+R).Three groups all applied TIVA(total intravenous anesthesia).At the time of subcutaneous suturing of the thoracotomy wound,intercostal nerves were block by the same thoracic surgery doctor in three groups.The group R used intercostal nerve block with 0.5% ropivacaine.The group P used intercostal nerve block with 0.5mg/kg pentazocine.The group P+R used intercostal nerve block with0.5mg/kg pentazocine combined with 0.5% ropivacaine.Follow up and record the patients visual analogue scales(VAS)in quiet and cough at the time of extubation(T1)and 1h(T2),2h(T3),6h(T4),8h(T5),12h(T6),24h(T7)after extubation.Record the related postoperative adverse reactions incidence and the usage of analgesics.One-Way ANOVA and Chi-squared test was conducted with p less than 0.05 as significant level using SPSS software version 23.0.Results:1.it is not statistically significant to compare with the general informationand operation condition of patients in three groups(p>0.05).2.Three groups of postoperative VAS score when quiet at each time point were less than 3 points,compared with group P+R,each time point VAS score were higher in group P and group R.Among three groups,there is no statistical differences(p>0.05).3.Compared with group P,T3~ T5 cough VAS score was obviously lower in group R(p<0.05),T2~ T6 cough VAS score was significantly lower in group P+R(p<0.05),group R T2~ T6 cough VAS score was higher than that in group P+R(p<0.05).4.Some nausea cases appear in the three groups,but there is no significant difference among the three groups(p>0.05).5.Patients of group P use analgesics in postoperative third hour,about4 hours earlier than group R;patients of group P+R use analgesics in postoperative tenth hour,significantly later than group R.Conclusions:Intercostal nerve block with pentazocine and ropivacaine can effectively reduce postoperative pain score,prolong the duration of analgesia,significantly enhance postoperative analgesia effect,lower the occurrence of side effects,and postpone the usage of analgesics after the video-assisted thoracoscopic surgery.