摘要
目的研究探讨盐酸右美托咪定复合罗哌卡因应用于腹横肌平面阻滞(B超引导下)的作用时间及镇痛效果。方法 120例剖宫产手术患者,随机分为Ⅰ组、Ⅱ组与Ⅲ组,每组40例。所有患者均进行剖宫产手术,术后实施双侧腹横肌平面阻滞(B超引导下),Ⅰ组给予1%罗哌卡因20 ml+生理盐水30 ml,Ⅱ组给予1%罗哌卡因20 ml+右美托咪定0.5μg/kg+生理盐水30 ml,Ⅲ组给予1%罗哌卡因20 ml+右美托咪定1.0μg/kg+生理盐水30 ml,持续监测无创血压、心电图、呼吸、脉搏血氧饱和度,记录术后视觉模拟评分法(VAS)评分、术后额外镇痛药使用情况及不良反应发生情况。结果观察发现,三组患者阻滞前后的血流动力学与脉搏血氧饱和度等情况均无明显变化,所有患者术后均未产生麻醉药物中毒现象。此外,三组患者呼吸抑制、皮肤瘙痒例数均为0,恶心、呕吐Ⅰ组3例,Ⅱ组3例,Ⅲ组4例,比较差异无统计学意义(P>0.05);额外镇痛药使用情况为Ⅰ组10例,Ⅱ组3例,Ⅲ组2例,Ⅱ组、Ⅲ组额外镇痛药使用明显少于Ⅰ组(P<0.05),而Ⅱ组与Ⅲ组额外镇痛药使用情况比较差异无统计学意义(P>0.05)。三组术后1、4 h VAS评分两两比较差异无统计学意义(P>0.05);术后8、12、24 hⅡ组、Ⅲ组患者VAS评分明显低于Ⅰ组(P<0.05),但同时间Ⅱ组与Ⅲ组患者VAS评分比较差异无统计学意义(P>0.05)。结论右美托咪定复合罗哌卡因腹横肌平面阻滞镇痛效果好,且右美托咪定能延长罗哌卡因镇痛时间,值得临床进一步应用和推广。
Objective To study the action time and analgesic effect of dexmedetomidine combined with ropivacaine for transversus abdominis plane block(ultrasound guided).Methods A total of120patients with caesarean section were randomly divided into groupⅠ,groupⅡand groupⅢ,with40cases in each group.All patients received cesarean section and bilateral transversus abdominis plane block(ultrasound guided)after operation.GroupⅠreceived1%ropivacaine20ml+normal saline30ml,groupⅡreceived1%ropivacaine20ml+dexmedetomidine0.5μg/kg+normal saline30ml,and groupⅢreceived1%ropivacaine20ml+dexmedetomidine1.0μg/kg+normal saline30ml.Non-invasive blood pressure,ECG,respiration,pulse oxygen saturation were continuously monitored,and postoperative visual analogue scale(VAS)score,use of additional analgesics and adverse reactions after operation were recorded.Results The Results showed that there were no obvious changes in hemodynamics and pulse oxygen saturation between the three groups before and after the block,and no poisoning by narcotic drugs occurred in all the patients.Three groups had0respiratory depression,skin itching case.GroupⅠhad3nausea and vomiting cases,which was3and4cases in groupⅡand groupⅢ,and their difference was no statistically significant(P>0.05).GroupⅠhad10cases with additional analgesics use,with were3and2cases in groupⅡand groupⅢ,groupⅡand groupⅢhad obviously less cases with additional analgesics use than groupⅠ(P<0.05).There was no statistically significant difference in additional analgesics use between groupⅡand groupⅢ(P>0.05).Three groups had no statistically significant difference in VAS score in postoperative1and4h(P>0.05).GroupⅡand groupⅢhad obviously lower VAS score in postoperative8,12and24h than groupⅠ(P<0.05).There was no significant difference in VAS score at same time points between groupⅡand groupⅢ(P>0.05).Conclusion Combination of dexmedetomidine and ropivacaine provides good analgesic effect for transversus abdominis plane block,and dexmedetomidine can prolong the analgesic time of ropivacaine.It is worthy of further clinical application and promotion.
作者
陈曼丽
侯铁军
陈沛华
杨校贤
陈杰忠
陈武龙
陈昕
CHEN Man-li;HOU Tie-jun;CHEN Pei-hua(Guangdong Province Dongguan City Changping Hospital, Dongguan 523573, China)
出处
《中国现代药物应用》
2017年第19期87-89,共3页
Chinese Journal of Modern Drug Application
关键词
右美托咪定
罗哌卡因
腹横肌平面阻滞
Dexmedetomidine
Ropivacaine
Transversus abdominis plane block
