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Effects of Ropivacaine-Containing Expansion Fluid on Stress Response and Postoperative Pain in Endoscopic Thyroid Surgery Patients under General Anesthesia with Tracheal Intubation |
JIANG Wei, et al |
The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Xi'an 710061, China |
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Abstract Objective: To analyze the positive effects of ropivacaine-containing inflation fluid on stress response and postoperative pain in patients undergoing endoscopic thyroidectomy under tracheal intubation and general anesthesia. Methods: 72 patients underwent endoscopic thyroidectomy under tracheal intubation and general anesthesia were randomly divided into study group (n=36) and control group (n=36). anesthesia They were subcutaneously injected with inflation fluid for auxiliary anesthesia. The inflation fluid of the control group was normal saline. The inflation fluid of the study group was 20 ml ropivacaine hydrochloride at 0.75% concentration and normal saline. The concentrations of stress indexes such as MAP, HR and plasma cortisol (Cor) of the two groups before induction (T0), before injection of inflation fluid (T1), immediately after the end of surgery (T2) and at extraction time of tracheal catheterization (T3) were recorded. Postoperative pain was assessed by the related scores at 10 min after surgery (T4), 30 min after surgery (T5) and 12h after surgery (T6). The incidence of adverse events during the perioperative period was statistically analyzed. Results: MAP, HR and Cor in both groups were significantly increased from T0 to T2 in turn, and they significantly decreased at T3 (P<0.05). There was no significant difference in MAP, HR or Cor at T0 and T1 between the two groups (P>0.05). MAP, HR and Cor in the study group were significantly lower than those in the control group at T2 and T3 (P<0.05). The VAS score and Ramsay sedation score at T5 were significantly lower than those at T4 in the two groups (P<0.05). The VAS score and Ramsay sedation score in the study group were significantly lower than those in the control group at T4 and T5. The BCS comfort score was significantly lower than that in the control group at T5 (P<0.05). There was no significant difference in the incidence of adverse reactions during perioperative period between the study group and the control group (22.22% vs 16.67%) (P>0.05). Conclusion: The swelling solution containing ropivacaine hydrochloride can significantly alleviate the stress reaction caused by endoscopic thyroidectomy, provide satisfactory analgesic effect and improve the comfort of patients.
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