右美托咪定联合罗哌卡因髂筋膜间隙阻滞对老年患者股骨手术术后镇痛的影响  

Effects of Dexmedetomidine Combined with Ropivacaine in Fascia Iliaca Compartment Block for Postoperative Analgesia after Elderly Patient Femoral Surgery

作　　者：张乾[1] 程芳[1] 万军芳[1] 颜凤凤[1] ZHANG Qian CHENG Fang WAN Junfang et al.(The Affiliated Lianyungang Oriental Hospital Bengbu Medical College, Lianyungang City, J iangsu Province 22204)

机构地区：[1]蚌埠医学院附属连云港市东方医院,江苏省连云港市222042

出　　处：《医学理论与实践》2017年第9期1264-1266,共3页The Journal of Medical Theory and Practice

基　　金：蚌埠医学院研究生科研创新计划项目(Byycx1550)

摘　　要：目的:探讨右美托咪定联合罗哌卡因髂筋膜间隙阻滞(FICB)对老年患者股骨手术术后镇痛的影响。方法:选择40例60~80岁ASAⅠ~Ⅲ级拟择期行股骨手术患者,随机分为两组(n=20):罗哌卡因组(R组)和右美托咪定联合罗哌卡因组(RD组)。术前所有患者均在超声引导下行FICB,R组用0.30%罗哌卡因30ml,RD组用0.30%罗哌卡因加1μg/kg右美托咪定的混合液30ml,术毕行患者自控静脉镇痛(PCIA)。记录患者术后4、8、18和42h患肢制动下的视觉模拟评分(RVAS)、患肢股四头肌等长收缩下的视觉模拟评分(PVAS)、警觉/镇静评分(OAA/S)及镇痛泵内舒芬太尼的消耗量,观察术后不良反应。结果:在术后8、18h时,RD组患者RVAS、PVAS明显低于R组(P<0.05)。在术后8、18和42h时,RD组患者镇痛泵内舒芬太尼消耗量低于R组(P<0.05)。RD组患者中有2例在术后4h出现心动过缓,R组无心动过缓发生。结论:右美托咪定联合罗哌卡因髂筋膜间隙阻滞能增强老年患者股骨手术术后的镇痛效果,减少术后镇痛药的用量。Objective： To investigate effects of dexmedetomidine combined with ropivacaine in Fascia lliaca Compart- ment Block （FICB） after elderly patient femoral surgery. Methods： Forty ASA Ⅰ-Ⅲ physical status patients, aged 60 80 years, scheduled for femoral surgery, were randomly divided into two groups （n= 20 each） using a random number table： ropivacaine group （group R） and ropivacaine combined with dexmedetomidine group （group RD）. All the patients received FICB before operation,30ml 0. 30% ropivacaine was injected in group R, 30ml 0. 30% ropivacaine combined with 1μg/kg dexmedetomidine was injected it1 group RD. After operation, two groups both received patient-controlled intravenous analgesia （PCIA）. In this study, rest visual analogue scale （RVAS）, passive visual analogue scale （PVAS）, the observer＇s assessment of alertness/sedation scale （OAA/S）, sufentanil consumption of PCIA and complications postoperative were recorded at postoperative 4,8,18,42h. Results： RVAS scores and PVAS scores were found lower in the group RD than in the group R at postoperative 8,18h （P〈0. 05）. The sufentanil consumption of PCIA was lesser in group RD than group R at postoperative 8,18,42h （P〈0.05）. Bradycardia was observed in 2 patients in group RD at postoperative 4h. Conclusion： It is concluded that dexmedetomidine combined with ropivacaine in FICB could enhance the postoperative analgesic effect in elderly patient femoral surgery and decrease the consumption of postoperative anal gesic.

关 键 词：右美托咪定 罗哌卡因 髂筋膜间隙阻滞 术后镇痛 

分 类 号：R683.42[医药卫生—骨科学]