Analyse Of Post-operative Analgesic Effect Of Local Spray Anesthesia With Ropivacaine For Thyroidectomy

Objective:To investigate the effect of ropivacaine on post-operative pain,sprayed under the superficial fascia before operation ending,and provide reference for clinical multimode postoperative analgesia,for patients undergoing thyroidectomy under general anesthesia.Methods:Forty females,ASA physical status ?-?,for thyroid surgery,form January 2017 to January 2018,were selected and randomized to two groups(n=20 each),group A and group B.General anesthesia was induced with midazolam 0.03mg/kg,eomidate 0.3mg/kg,sufentanil 0.3 ?g/kg,cisatracurium 0.2mg/kg,until loss of eyelash reflexes,the tracheal intubation under glidescope.Anesthesia was maintaried with propofol intravenously and inhalation of sevoflurane under mechanical ventilation.When the patient's blood pressure fluctuates more than 20%of the basic blood pressure,the patient is given a clinical intervention,given the anesthetic or different hypotensor or antihypertensive drugs according to the situation.Patients were randomized to two groups:Group A(n=20),The fasciae were sprayed 0.9%normal saline 10ml before the end of the operation.Group B(n=20),The fasciae were sprayed 0.5%ropivacaine 10ml before the end of the operation.The double blind method is used in this experiment,preparation of drugs by an assistant before each operation,the follow-up was performed by another physician.The preoperative T0(basal blood pressure and heart rate),Tl(extubation time),T2(postoperative 1H),T3(postoperative 4h),T4(postopera-tive 8h),T5(postoperative 16h),T6(postoperative 24h),blood pressure,heart rate,VAS score and nausea and vomiting were recorded respectively.Results:1.Comparison of systolic blood pressure,diastolic blood pressure and heart rate at the time of T1-T6 in two groups:In group A,systolic blood pressure,diastolic blood pressure and heart rate at T1,T2,T3 and T4 were significantly higher than those in group B(P<0.05).At the time of T5 and T6,there was no significant difference in systolic blood pressure,diastolic blood pressure and heart rate between the two groups(P>0.05).2.Comparison of VAS score at the time of T2-T6 in two groups:In the group A,the VAS score at the time of T2-T4 was 3.65±0.81?3.95±0.76 and 4.1 ±0.79,and in the group B,the VAS score at the time of T2-T4 was 2.7±0.92?3.3±0.86 and 3.5±0.76,the group A were significantly higher than those in group B(P<0.05).At the time of T5 and T6,there was no statistical difference in VAS score between the two groups(P>0.05).3.Comparison of Ramsay score at the time of T1 in two groups:in the group A,the Ramsay score was 3.55±0.69,and in the group B,the Ramsay score was 2.6±1.19.There were difference in statistics between the two groups(P<0.05)4.Comparison of incidence of postoperative nausea and vomiting in two groups:The group A was 40%,and the group B was 10%.Conclusions:Spraying 0.5%ropivacaine 10ml under the fascia layer for thyroidectomy,before operation ending can play a good early postoperative analgesia effect,improve the comfort of patients,reduce the use of analgesics,accelerate postoperative recovery,and have no effect on wound healing.