Abstract:

Objective: To study the effects of expansion of ropivacaine hydrochloride liquid on the postoperative analgesia, sedation, hemodynamic effects and adverse drug reactions of the patients underwent endoscopic thyroidectomy,and to explore its clinical effectiveness and safety. Methods: Forty patients who were to undergo endoscopic thyroidectomy via chest-breast approach were randomly assigned to saline solution group and expansion liquid of ropivacine hydrochloride group (ropivacaine group,n=20).The mean arterial pressure( MAP ) and heart rate( HR) were also evaluated at the following time points: preoperative evaluation(T₀), before local anesthetic infiltration(T₁), at the end of the operation(T₂); the blood loss, the operation time, the postoperative drainage, and the hospital duration of the patients in two groups were recorded;the nausea and vomiting, the respiratory depression,the toxicity response,the infection,and the recurrent laryngeal nerve injury during 24 h after operation were recorded. The postoperative pain scores were assessed at extubaltion(T₃),30 min(T₄),2 h(T₅),6 h(T₆),12 h (T₇) and 24 h (T₈) after extubation using Visual Analog Scale (VAS). The postoperative Ramsay scores were assessed at T₃ and T₄. Results: There were no significant differences in MAP and HR at T₀ and T₁ of the patients between two groups(P > 0.05). Compared with saline solution group, the MAP and HR at T₂ and T₃ of the patients in ropivacaine group were significantly decreased(P < 0.05).There were significant differences in the blood loss, the operation time,the postoperative drainage, and the hospital duration of the patients between two groups(P < 0.05).The number of patients required postoperative analgesia and the number patients with nausea and vomiting in ropivacaine group were decreased compared with saline solution group(P < 0.05). Compared with saline group, the VAS scores at T₃, T₄, T₅, T₆, T₇ and T₈ of the patients in ropivacaine group were significantly decreased(P < 0.05); the Ramsay scores at T₃ and T₄ of the patients in ropivacaine group were also decreased significantly(P < 0.05). Conclusion: Expansion liquid of ropivacaine hydrochloride can reduce the stress response during endoscopic thyroidectomy effectively and reduce the postoperative pain and injury induced by operation.

Key words: ropivacaine, postoperative pain, endoscopic thyroidectomy