右旋美托咪定用于子宫全切术后硬膜外镇痛的效果分析  

Effects of postoperative epidural analgesia with dexmedetomidine after hysterectomy

作　　者：胡宇[1,2] 赵盼盼[2] 许春梅[2] 朱杨子[2] 黄河[2] 刘璐[2] 史晓甜[2] 武玉清[2] 

机构地区：[1]徐州医学院附属徐州市妇幼保健院麻醉科,江苏徐州221009 [2]徐州医学院江苏省麻醉学重点实验室,江苏徐州221004

出　　处：《徐州医学院学报》2014年第11期739-741,共3页Acta Academiae Medicinae Xuzhou

基　　金：国家自然科学基金（81070889、81171013）;江苏省高校自然科学基金重大项目（10KJA320052）.

摘　　要：目的探讨右旋美托咪定用于子宫全切术后硬膜外镇痛的效果。方法选择ASA1—2级、行子宫全切手术的患者60例，采用腰硬联合麻醉，术后行硬膜外自控镇痛，分为2组，每组30例。泵内配方为吗啡组（M组）：吗啡5mg＋罗哌卡因200mg＋生理盐水至100ml；右旋美托咪定组（D组）：右旋美托咪定1．5μg/kg＋罗哌卡因200mg＋生理盐水至100ml。背景输注速度均为4ml／h。观察患者术后6、12、24h的镇痛效果和平均动脉压（MAP）、心率变化，并观察恶心呕吐及皮肤瘙痒的发生情况。结果2组术后6、12、24h的镇痛效果及MAP、心率变化的差异无统计学意义。D组恶心呕吐及皮肤瘙痒的发生率显著低于M组（P〈0．05）。结论右旋美托咪定复合罗哌卡因进行子宫全切术后硬膜外镇痛安全有效，且不良反应较少。Objective To explore the effects of dexmedetomidine in hysterectomy for epidural anesthesia. Methods A total of 60 ASA Ⅰ - Ⅱ patients were enrolled into the current study. They underwent hysterectomy and received combined spinal - epidural anesthesia followed by self - control epidural analgesia after operation. These patients were randomly divided into a morphine group who were given 5 mg morphine ＋ 200 mg ropivacain ＋ normal saline solution to 100 ml （30 patients） and a dexmedetomidine group who were treated with 1.5 μg/kg dexmedetomidine ＋ 200 mg ropivacain ＋ normal saline solution to 100 ml （30 patients）. The background infusion rate was 4 ml/h. Then, analgesic effects, mean artery pressure （MAP） and changes in heart rate were detected 6 hours, 12 hours and 24 hours after surgery were observed. Meanwhile, the incidences of nausea, vomiting and skin itching were recorded. Results There was no significant difference as to analgesic effects, MAP and heart rate changes between both group 6 hours, 12 hours and 24 hours after surgery. The dexmedetomidine group presented obviously lower incidences of nausea, vomiting and skin itching in comparison with the morphine group （ P 〈 0.05 ）. Conclusion The combination of dexmedetomidine and ropivacaine can be applied for postoperative analgesia, which is safe and effective, with little side effects.

关 键 词：右旋美托咪定 吗啡 硬膜外镇痛 

分 类 号：R614.4[医药卫生—麻醉学]