关键词: 罗哌卡因, 超声引导, 阴部神经阻滞, 混合痔切除, 炎症因子, 疼痛

Abstract:

Objective To explore the efficacy of ultrasound-guided pudendal nerve block (PNB)

with different concentrations of ropivacaine on inflammatory factors and pain in patients with mixed

hemorrhoidectomy. Methods From January 2020 to March 2021, 90 patients underwent elective mixed

hemorrhoidectomy at Fuxing Chancheng Hospital of Foshan City were randomly divided into R1, R2 and R3 groups, Each group contained 30 cases; The three groups of patients underwent bilateral PNB

under ultrasound guidance; The concentration of ropivacaine in the R1 group was 0.25%, the R2 group

was 0.375%, and the R3 group was 0.5%;Compare the pain scores of the three groups at the 1h (T0), 6h

(T1), 12h (T2), 24h (T3) and 48h (T4) after the operation of the three groups; The levels of inflammatory

factors in the three groups before and 24h after the operation were compared; The incidence of adverse

reactions in the three groups were compared. Results The visual analogue scale(VAS) scores of the R2

and R3 groups from T1 to T4 were lower than that of the R1 group at the same time, and the difference

were statistically significant (P ＜ 0.05);There were no statistically significant difference in the VAS

scores of the R2 and R3 groups at T1 ～ T4 (P ＞ 0.05); the levels of tumor necrosis factor(TNF)-α,

interleukin(IL)-6, IL-8 and IL-12 in the R2 and R3 groups were higher than that at 24h after surgery

in the R1 group at the same period, the difference were statistically significant (P ＜ 0.05);There were

no significant difference in the levels of TNF-α, IL-6, IL-8 and IL-12 in the R2 and R3 groups at 24h

after surgery (P ＞ 0.05); There were no significant difference in the adverse reactions between the three

groups (P ＞ 0.05). Conclusion 0.375% and 0.50% concentration of ropivacaine applied to ultrasoundguided

PNB compare with 0.25% concentration of ropivacaine, the postoperative pain of patients is

significantly reduced, the inflammatory response is significantly reduced, and the adverse reactions are

equivalent.

Key words: Ropivacaine, Ultrasound guidance, Pudendal nerve block, Mixed hemorrhoidectomy; Inflammatory factor, Pain