不同剂量盐酸右美托咪定鞘内注射对盐酸罗哌卡因蛛网膜下腔阻滞效果的影响  

Effects of Different Doses of Dexmedetomidine Hydrochloride Intrathecal Injection on Ropivacaine Hydrochloride Spinal Block

作　　者：姜景卫[1] 鲁华荣[1] 毛桂琴[1] 祝雪芬[1] 毛晨俊[1] 

机构地区：[1]浙江省江山市人民医院麻醉科,江山324100

出　　处：《医药导报》2015年第9期1181-1184,共4页Herald of Medicine

基　　金：浙江省医学会临床科研基金资助项目(2012ZYC-A93)

摘　　要：目的探讨鞘内注射不同剂量盐酸右美托咪定对罗哌卡因蛛网膜下腔阻滞(脊麻)效果的影响。方法择期行下肢手术患者40例,随机分为对照组和治疗组,每组20例,分别鞘内注射盐酸右美托咪定4,12μg,再缓慢注入0.75%罗哌卡因1.5 m L;记录麻醉前(t0)与注药后5,10,15,20,25,30 min的收缩压、舒张压、心率、脉搏氧饱和度及Ramsay评分;记录感觉、运动阻滞的起效时间和持续时间,以及恶心、呕吐、呼吸抑制等不良反应发生情况。结果治疗组和对照组感觉阻滞起效时间分别为(6.9±2.6),(8.7±2.9)min(P<0.05);感觉阻滞持续时间分别为(130.8±20.1),(115.9±23.9)min(P<0.05);运动阻滞持续时间分别为(145.9±29.0),(130.0±30.1)min(P<0.05)。结论盐酸右美托咪定12μg鞘内注射可使罗哌卡因脊麻感觉阻滞起效时间增快、感觉和运动阻滞持续时间延长;并能维持血流动力学稳定,不增加恶心、呕吐、心动过缓和呼吸抑制等不良反应。Objective To investigate the effects of intrathecal different doses of dexmedetomidine hydrochloride in spinal block by ropivacaine hydrochloride. Methods Forty lower limb surgery scheduled for elective under spinal anesthesia,were randomly divided into 2 groups( n = 20 each) : the control and the treatment groups. The control and the treatment group were intrathecally injected with 4,12 μg dexmedetomidine hydrochloride respectively. The 0. 75% ropivacaine hydrochloride 1. 5m L was injected for spinal anesthesia.SBP,DBP,HR,Sp O2 and Ramsay Sedation Score were recorded before the spinal anesthesia conduct and thereafter every five minutes. And the onset and duration of block were recorded,adverse reaction like nausea,vomiting and respiratory depression were also observed. Results Compared with the control group,the onset of sensory block was shorter[( 6.9±2.6) min vs( 8. 7 ± 2. 9) min]( P < 0.05),and the duration of sensory and motor block was longer in the treatment group [( 130.8±30.1) min vs( 115.9±23.9) min]( P< 0.05) and[( 145.9± 29.0) min vs( 130.0± 30.1) min]( P<0.05). Conclusion Intrathecal dexmedetomidine hydrochloride at 12 μg improves anesthesia via shortening the sensory block onset and prolonging sensory and motor block,which maintains hemodynamically stable,and does not generate adverse reactions as nausea,vomiting,bradycardia and respiratory depression.

关 键 词：右美托咪定 盐酸 注射 脊髓 麻醉 脊椎 

分 类 号：R971.2[医药卫生—药品] R683.42[医药卫生—药学]