右美托咪定超前镇痛在下肢骨折手术患者的应用  

Application of preemptive analgesia with dexmedetomidine in patients undergoing operation for lower limb fractures

作　　者：赵以松[1] 孟祥奇[2] 喻翔卿[1] 徐雪芬[1] 熊远洪 

机构地区：[1]南京中医药大学附属苏州市中医医院麻醉科,江苏省215009 [2]南京中医药大学附属苏州市中医医院骨科,江苏省215009

出　　处：《江苏医药》2014年第2期167-169,共3页Jiangsu Medical Journal

基　　金：2012年度江苏省中医药管理局基金(LZ11147)

摘　　要：目的探讨右美托咪定超前镇痛在下肢骨折手术患者应用的效果。方法下肢骨折切开复位内固定手术患者80例,随机均分为两组:A组术前10min泵注右美托咪定0.5μg/kg;B组泵注生理盐水2ml作对照。手术均在罗哌卡因腰麻下完成。两组术后均使用芬太尼患者自控静脉镇痛(PCIA),比较两组镇静、镇痛效果和不良反应发生情况。结果 A组术中Ramsay镇静评级优于B组(P<0.05),术后6、12、24、36和48h的VAS疼痛评分低于B组(P<0.05)。两组镇痛相关不良反应发生率相仿(12.5%vs.10.0%)(P>0.05)。A组术后48h芬太尼用量少于B组[(14.1±3.0)μg/kg vs.(15.9±3.8)μg/kg],自控镇痛泵按压次数少于B组[(5.4±5.8)次vs.(9.7±5.8)次](P<0.05)。结论右美托咪定超前镇痛能够改善术后芬太尼PCIA效果,并能减少芬太尼使用量。Objective To investigate the outcomes of preemptive analgesia with dexmedetomidine in patients undergoing operation for lower limb fractures. Methods Eighty patients with lower limb fractures were equally randomized into two groups of A（dexrnedetomidine 0.5μg/kg was pumped intravenously at 10 rain before surgical incision） and B（normal saline 2 ml was used instead of dexmedetomidine）. The operation was performed under lumbar anesthesia with ropivaeaine. Postoperative patient-controlled intravenous analgesia （PCIA） was carried out with fentanyl. The analgesia and sadation efficacy and analgesia-related side effects were compared between two groups. Results Ramsay sedation grade during operation was better in group A than that in group B （P〈0. 05）. VAS pain scores during PCIA were lower in group A than those in group B（P〈0. 05）. The incidence rates of analgesia-related side effects were similar in both groups （12. 5 % vs. 10. 0%） （P〈0. 05）. The comsumption of fentanyl for PCIA in 48 h was less in group A than that in group B [（14. 1±3.0） μg/kg vs. （15.9±3.8） μg/kg] （P〈0. 05）. So did the number of PCA[-（5.45, 8） times vs. （9.7 ± 5.8） times] （P〈0. 05）. Conclusion Preemptive analgesia with dexmedetomidine can improve the efficacy of postoperative analgesia and reduce the needs for fentanyl.

关 键 词：右美托咪定 超前镇痛 

分 类 号：R614[医药卫生—麻醉学]