球周麻醉应用罗哌卡因添加右美托咪定的效果  

The efficacy of Dexmedetomidine added to Ropivacaine in peribulbar anesthesia

作　　者：徐广[1] 张陆希 万文萃[2] 张卫[1] 韩雪萍[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,郑州450052 [2]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2016年第8期606-609,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：【摘要】目的评价玻璃体切除术球周麻醉应用罗哌卡因（Ropivacaine）中加入右美托咪定（Dexmedetomidine）的效果。方法玻璃体切除术60例（60眼）随机分为两组：R组，30例，单纯应用0．75％罗哌卡因进行球周麻醉。RD组，30例，在0．75％罗哌卡因中添加右美托咪定0．5斗g／kg进行球周麻醉。观察眼球感觉阻滞和运动阻滞的起效时间和持续时间。观察注药后3、6、9、12及15min眼球运动阻滞情况。记录术后1、2、6、12及24h疼痛视觉模拟评分。结果RD组患者感觉阻滞起效时间（7．44±1．429）min短于R组的（8．48±2．141）min（t=2．215，P=0．031）。RD组患者运动阻滞起效时间（11．37±1．033）min短于R组的（14．03±1．299）min（t=8．798，P=0．000）。RD组患者感觉阻滞的持续时间（7．10±1．709）h长于R组的（5．70±1．264）h（t=3．608，P=0．001）；RD组患者运动阻滞的持续时间（6．27±1．337）h长于R组的（4．73±1．081）h（t=4．885，P=0．000）。RD组患者注药后6min和9min眼球运动阻滞评分小于R组（t=4．176，P=0．000；f=2．316，P=0．025）。RD组患者术后6h和12h疼痛视觉模拟评分小于R组（t=5．357，P=0．000；t=2．299，P=0．025）。结论玻璃体切除术球周麻醉应用罗哌卡因中加入右美托咪定能够缩短感觉阻滞和运动阻滞起效时间，延长感觉阻滞和运动阻滞持续时间，并具有更好的术后镇痛作用。Objective To evaluate the efficacy of dexmedetomidine added to ropivaeaine in peribulbar anesthesia for vitrectomy. Methods A total of 60 eyes of 60 patients scheduled for vitrectomy with peribulbar anesthesia were randomly divided into two groups. Group R of 30 patients received ropivacaine O. 75% and group RD of 30 patients received dexmedetomidine 0.5 μg/kg and ropivacaine 0.75%. The onset time and duration of sensory and motor blocks were observed and compared. The ocular movement blocks were observed at 3, 6, 9, 12 and 15 rain after injection. The analogue scale scores of pain were recorded at 1, 2, 6, 12 and 24 h after surgery. Results The sensory block onset time of group RD, （7.44 ± 1. 429） rain, was shorter than that of group R, （8.48 ±2. 141 ） rain （t =2. 215 ,P =0. 031 ）. The motor block onset time of group RD, （ 11.37 ± 1. 033 ） rain, was shorter than that of group R, （ 14.03 ± 1. 299） rain （ t = 8. 798, P = 0. 000）. The sensory block duration of group RD, （7.10 ± 1. 709） h, was longer than that of group R, （5.70 ± 1. 264） h （t =3. 608 ,P =0. 001 ）. The motor block duration of group RD,（6.27 ±1.337） h,was longer than that of group R （4.73 ± 1. 081） h （t =4. 885,P =0.000）. The ocular movement block scores of patients in group RD at 6 min and 9 min were less than that of group D（ t = 4. 176, P = 0. 000 ; t = 2. 316, P = 0. 025 ）. The analogue scale scores of pain in group RD at 6 h and 12 h were less than that of group R（t = 5. 357, P = 0. 000; t = 2. 299, P = 0. 025）. Conclusion Dexmedetomidine as an adjuvant to ropivacaine in peribulbar anesthesia for vitrectomy can accelerate the onset time of sensory and motor blocks, prolong the duration of sensory and motor blocks, and provide more effective postoperative analgesia.

关 键 词：玻璃体切除术 球周麻醉 右美托咪定 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]