关键词: 口腔颌面肿瘤, 股前外侧皮瓣, 股神经阻滞, 股外侧皮神经阻滞, 舒芬太尼, 地佐辛, 镇痛

Abstract: PURPOSE: To investigate the efficacy and safety of regional analgesia combined with opioid analgesia in patients with radical resection of oral and maxillofacial tumors and reconstruction with anterolateral thigh flap. METHODS: Sixty patients with oral and maxillofacial tumors were randomly divided into experimental group and control group. In the experimental group, ultrasound guided femoral nerve block combined with lateral femoral cutaneous nerve block were performed 30 minutes before operation ending, and 0.25% levobupivacaine (15 mL) was injected into the operation side, while PCIA was connected (sufentanil 1.5 μg/kg+ dezocine 0.1 mg/kg+ ramosetron 0.4 mg/ 0.9%NS 100 mL). Patients in the control group received PCIA 30min before operation ending (sufentanil 2 μg/kg+ dezocine 0.2 mg/kg+ ramosetron 0.6 mg/0.9%NS 100 mL). The general conditions, VAS and Ramsay scores at 6 h(T1),12 h(T2), 24 h(T3), 48 h(T4) after operation were observed, and the incidence of adverse reactions was recorded. The data were analyzed using SPSS 19.0 software package. RESULTS: There was no significant difference in VAS and Ramsay scores between the two groups at T1, T3, T4 (P>0.05). At T2, the VAS score of the experimental group was significantly higher than that of the control group (P<0.05). The adverse reaction rate of the experimental group was 10%, which was significantly lower than 36.6% in the control group (P<0.05). CONCLUSIONS: Regional analgesia combined with opioid analgesia for patients with radical resection of oral and maxillofacial tumors and reconstruction with anterolateral thigh flap had a definite effect and could reduce the opioid adverse reactions.

Key words: Oral and maxillofacial tumor, Anterolateral thigh flap, Femoral nerve block, Lateral femoral cutaneous nerve block, Sufentanil, Dezocine, Analgesia