Analgesic Effect Of Different Doses Of Dezocine Combined With Ropivacaine In Paravertebral Nerve Block After Radical Mastectomy

Objective:To evaluate the analgesic effect of different doses of dezocine combined with ropivacaine used in paravertebral nerve block after radical mastectomy.Method:Choose 60 cases of female patients undergoing elective radical mastectomy in the department of breast surgery of our hospital.Their aged 40 to 65 years old,ASA?or?level,body mass index?BMI?of 18.5²8 kg·m^-2.The sixty patients were divided into three groups with 20 cases in each group by the random number table method.All patients in the three groups completed the operation under total intravenous anesthesia,and TPVB was guided by ultrasound after the patients were awake after the operation:Low dose of dezocine group?group T1?,to inject 0.5%ropivacaine 20 ml containing 0.1 mg·kg^-1dezocine;Big dose of dezocine group?group T2?:to inject 0.5%ropivacaine 20 ml containing 0.15 mg·kg^-1 dezocine;Simple ropivacaine group?group C?,to inject 0.5%ropivacaine 20 ml.Intravenously administered sufentanil 0.1?g·kg^-1 if the patients resting VAS score greater than 4 points.Visual analogue scores?VAS?of the patients'resting state and motion state?active arm?at 2,6,12 and 24 h after surgery were recorded;Venous blood which was used to measure the serum cortisol concentration was collected at 2,6,12 and 24 h after the operation;The total amount of postoperative analgesics and adverse reactions were recorded.Results:Compared with group C,the VAS score of resting state and motion state?active arm?at each time point were lower in group T1 at 12and 24 hours after surgery,and the postoperative sufentanil dosage,adverse reactions like nausea and vomiting were reduced?P<0.05?;In T1 group,serum cortisol concentration was lower at each time point?P<0.05?.There was no significant difference in VAS scores,postoperative sufentanil dosage and serum cortisol concentrations between the T1 and T2groups?P>0.05?;However,compared with the T2 group,the incidence of postoperative adverse reactions of nausea and vomiting was lower in the T1group?P<0.05?.Conclusion:Compared with simple ropivacaine,TPVB with small dose of dezocine combined with ropivacaine under ultrasound guidance has a significantly enhanced analgesic effect and longer analgesic time.The dosage of postoperative analgesics and the incidence of adverse reactions decreased,and the degree of postoperative stress response decreased.This is of great significance for the rapid recovery of patients after surgery.