| Background:With the development of national economy and transportation industry,people are injured due to car accidents or falls increasingly,and chest trauma and rib fracture are becoming common.Rib fractures are often associated with pulmonary contusion,hemopneumothorax,atelectasis and other common complications.Chest trauma is currently the second leading cause of traumatic death[1],secondary only to craniocerebral injury.According to the related literature,rib fractures of chest injury and its complications cause trauma mortality rates as high as 25%.According to the clinical data,chest pain of rib fractures is the main causes of chest trauma complications[1].Analgesia is one of the most important measures of ERATS（Enhanced Recovery After Thoracic Surgery）[2],so more and more scholars pay attention to fractured ribs analgesia.Objective:We compared and analyzed the analgesic effect of intercostal nerve blocking during operation with ropivacaine injection,a long-acting local anesthetic,on patients with fractured ribs of internal fixation.Method:1.We studied 139 cases of rib fractures with pulmonary contusion in the thoracic surgery intensive care unit of the Third Hospital of Hebei Medical University from February 2018 to February 2019.All patients underwent surgery within 7 days of admission.2.139 subjects were randomly divided into two groups:group A and group B.There was no difference in AIS between the two groups.Seventy patients in group A were treated with internal fixation of rib fracture+ropivacaine intercostal nerve block analgesia,while 69 patients in group B were treated with internal fixation of rib fracture+continuous microinjection of analgesics in veins.3.Monitor A and B two groups of patients with preoperative 3 days,2days,1 day,postoperative 1 day,2 days,3 days closely.And indicators of the two groups such as pain scores（visual analogue scales）,the blood oxygen partial pressure and heart rate,respiratory frequency,white blood cell count,incision infection,complications are analyzed statistically before and after surgery respectively.Results:Patients in group A had lower pain scores after surgery,and the difference was statistically significant（P<0.001）.Patients in group B had lower pain scores after surgery,and the difference was statistically significant（P<0.05）.The postoperative pain score of group A（P<0.001）was significantly lower than that of group B（P<0.05）.Before surgery,there was no significant difference in pain scores between group A and group B（P>0.05）.The results showed that the partial blood oxygen pressure increased after surgery,and the difference was statistically significant（P<0.05）.The white blood cell count decreased on the third day after surgery,and the difference was statistically significant（P<0.05）.Respiratory frequency decreased after surgery,and the difference was statistically significant（P<0.001）.Heart rate decreased after surgery,and the difference was statistically significant（P<0.001）.After the operation,there was no significant increase in the blood oxygen partial pressure between group A and group B,and the difference was not statistically significant（P>0.05）.After the operation,the white blood cell count of group A was not significantly lower than that of group B,and the difference was not statistically significant（P>0.05）.After surgery,the heart rate of group A was significantly lower than that of group B,and the difference was statistically significant（P<0.001）.The postoperative respiratory rate of group A was significantly lower than that of group B,and the difference was statistically significant（P<0.001）to evaluate the analgesic effect of ropivacaine.Conclusion:The analgesic method of intercostal nerve block with ropivacaine injection during internal fixation of rib fractures is simple and easy to operate,which can effectively control the chest pain,reduce the complications of rib fractures combined with pulmonary contusion,and is conducive to the early recovery of patients. |
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