Application and effect of multivesicular liposomal ropivacaine in non-intubated thoracoscopy surgery

Objective To investigate the application and effect of multivesicular liposomal ropivacaine in non-intubated thoracoscopy surgery and the incidence of perioperative complications. Methods A total of 60 patients undergoing non-intubated thoracoscopy surgery in our hospital between January,2016 to September,2016 were enrolled and randomly divided into group A (0.2% ropivacaine),group B (0.2% ropivacaine and multivesicular liposomal ropivacaine) and group C (0.1% ropivacaine and 0.4 μg/ml sufentanil) with 20 cases in each group.Epidural catheter was placed at the T₆-T₇ level before the surgery,and 2 mg morphine was injected for analgesia.The propofol and dexmedetomidine were given by a infusion pump during the operation.The patients breathe independently via face mask.The changes of respiration and blood circulation were observed among the three groups.Postoperative VAS pain score at 1,4,8 and 24 hours after the operation were recorded.The complications such as intraoperative cough,hypoxemia,hypercapnia and postoperative nausea and vomiting were also recorded.The multivesicular liposomal ropivacaine was prepared with 0.2% ropivacaine,phospholipid,cholesterol,three oleic acid glyceride and L-lysine as materials by multiple emulsion process.The multivesicular liposomal ropivacaine was a spherical body,its internal structure consisted of the polycystic bubble,the size was of 7-30 μm,the average particle size was (15.36±7.87)μm;The release rate of drug was 65% at 6 hours,90% at 24 hours,and complete within 48-60 hours. Results In terms of blood pressure in surgery,there was significant difference between group A compared with group B and group C (P<0.05).In terms of respiratory frequency,the respiratory rate of group A and group B were lower than that in group C when artificial pneumothorax and 30 minutes after artificial pneumothorax (P<0.05);In group A,4 and 8 hours after surgery were higher than those in group B and group C (P<0.05).In terms of complications,the incidence of nausea and vomiting in group A was higher than that in group B during surgery (P<0.05).In terms of the resting and cough pain VAS score,B group was lower than A and C group after surgery 4 and 8 hours (P<0.05). Conclusion The multivesicular liposomal ropivacaine can reduce the perioperative complications of non-intubated thoracoscopy surgery and achieve accurate quantitative release of anesthetic drugs,and has the characteristics of sustained release and quantitative release,which is worthy of clinical application.