ĐÁNH GIÁ TÁC DỤNG GIẢM ĐAU SAU PHẪU THUẬT UNG THƯ VÚ CỦA GÂY TÊ MẶT PHẲNG CƠ RĂNG TRƯỚC DƯỚI HƯỚNG DẪN SIÊU ÂM BẰNG LEVOBUPIVACAIN 0,25% PHỐI HỢP 4MG DEXAMETHASONE

Abstract

Objects: To compare the analgesic effect of ultrasound-guided serratus anterior plane block using levobupivacaine 0,25% with mixture of levobupivacaine 0,25% and 4 mg dexamethasone. Methods: RCT study on 70 patients divided two groups. Group 1: Serratus anterior plane block under ultrasound guidance with 30ml levobupivacaine 0,25%. Group 2: Serratus anterior plane block under ultrasound guidance with mixture of 30ml levobupivacaine 0,25% and 4 mg dexamethasone. The patient was fitted with IV-PCA morphine, with a bolus dose of 1mg/time, a lock-in time between 2 bolus injections was 8 minutes, a maximum dose of 6 times/hour and was instructed to start when VAS – score ≤ 3. Results: VAS – score during rest/movement of group I is higher than group II (VAS < 4, p > 0,05). The average time required for the first dose of morphine in group I is shorter than in group II (10,06 ± 2,19 hrs/25,16 ± 2,48 hrs, p < 0,01). The total dose of morphine consumed within 24 hrs, 48 hrs after surgery in group I is higher than group II (0/0,85 ± 0,21 mg, 1,57 ± 0,58/ 2,66 ± 0,63 mg, p < 0,01). Conclusion: Serratus anterior plane block under ultrasound guidance with a mixture of levobupivacaine and dexamethasone has a stable and longer-lasting pain-reducing effect compared to levobupivacaine.