右旋美托咪啶或芬太尼复合罗哌卡因腰麻用于子宫切除术的临床研究  

Clinical study of intrathecal dexmedetomidine or fentanyl as adjuvants to Ropivacaine

作　　者：杨晓燕[1] 初月美 常庆显[1] 邓红燕[1] 

机构地区：[1]海阳市人民医院,山东海阳265100

出　　处：《中国现代医学杂志》2012年第21期99-101,共3页China Journal of Modern Medicine

摘　　要：目的比较右旋美托咪啶复合罗哌卡因和芬太尼复合罗哌卡因腰麻用于子宫切除术的效果。方法60例ASA I-II级行子宫切除术的患者,随机分为右旋美托咪啶组(组D,n=30)和芬太尼组(组F,n=30),分别于L3-4腰穿成功后,注射5μg右旋美托咪啶复合12.5 mg罗哌卡因和25μg芬太尼复合12.5 mg罗哌卡因,观察感觉和运动神经的起效和维持时间、血液动力学变化、术后镇痛时间和副作用。结果右旋美托咪啶组感觉阻滞平面消退至S1时间为(420±20)min,较芬太尼组(190±19)min显著延长(P<0.01)。右旋美托咪啶组运动阻滞消退达到Bromage 0时间为(390±19)min,较芬太尼组(70±16)min显著延长(P<0.01)。结论与芬太尼组比较,鞘内右旋美托咪啶运动和感觉神经阻滞时间长,术后24 h需要镇痛药的量少。[ Objective ] To evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine or fentanyl given intrathecally with 0.5% ropivacaine. [ Methods ] Sixty patients classified in American Society of Anesthesiologists classes I and II for elective abdominal hysterectomy were studied. Patients were randomly divided into receive either 12.5 mg ropivacaine plus 5 p,g dexmedetomidine （group D, n =30） or 12.5 mg ropivaeaine plus 25 p,g fentanyl （group F, n =30） intrathecal. [ Resuits ] The sensory and motor block time in group D was longer significantly than that in group F. The mean time of sensory regression to S1 was （420±20）min in group D and （190±19）min in group F （P 〈0.01）. The regression time of motor block to reach modified Bromage 0 was （390±19）min in group D and （70±16）min in group F （P 〈0.01）. [Conclusions ] Intratheeal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand for rescue analgesics in 24 h as compared to fentanyl.

关 键 词：罗哌卡因 右旋美托咪啶 芬太尼 腰麻 

分 类 号：R982[医药卫生—药品]