不同剂量右美托咪定联合罗哌卡因腹横筋膜阻滞对术后镇痛的影响  

Effect of Different Doses of Dexmedetomidine Combined with Ropivacaine in Transverse Abdominal Plane Block on Postoperative Analgesia

作　　者：宋幽平 王翔宇 潘柏言 杨露露 龙波[1] SONG Youping;WANG Xiangyu;PAN Boyan;YANG Lulu;LONG Bo(Department of Anesthesiology,Shengjing Hospital,China Medical University,Shengyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院麻醉科

出　　处：《中国医科大学学报》2019年第8期734-737,742,共5页Journal of China Medical University

摘　　要：目的观察不同剂量右美托咪定加入罗哌卡因中用于腹横筋膜阻滞对妇科开腹手术术后镇痛的效果,探讨右美托咪定加入局麻药中最佳的临床剂量。方法选择于我院妇科行开腹手术的60例患者,随机分为对照组和3个试验组,每组15例。各组罗哌卡因浓度相同,所用药液容量相同,对照组加入生理盐水,试验组加入右美托咪定,剂量分别为6.25μg、12.5μg和25μg。全身麻醉后于超声引导下完成双侧腹横筋膜阻滞。记录患者离开术后恢复室即刻和距离双侧阻滞结束的4 h、8 h、12 h、24 h和48 h的视觉模拟评分法(VAS)评分;第1次使用自控镇痛(PCA)泵的时间;术后48 h镇痛泵按压次数;术后不良反应。结果对照组、6.25μg组、12.5μg组、25μg组术后第1次使用PCA距离阻滞结束的时间分别为4.60 h、4.64 h、7.92 h和11.00 h。结论右美托咪定联合罗哌卡因行腹横筋膜阻滞时,阻滞镇痛时间呈剂量依赖性增加,且无明显不良反应。Objective To observe the analgesic effects of different doses of dexmedetomidine combined with ropivacaine and determine the appropriate clinical dose under ultrasound-guided transversus abdominis plane(TAP) block in gynecologic open surgery. Methods Sixty cases of gynecologic laparotomy in our hospital were randomly divided into 4 groups,with 15 cases in each group. The ropivacaine concentration and liquid volume were the same in all groups. In the control group,saline was administered,and in the 3 experimental groups,6.25,12.5,and 25 μg of dexmedetomidine were administered. The visual analogue scale(VAS) scores were recorded for leaving the post-anesthesia care unit 4,8,12,24,and 48 h after recovering from the bilateral TAP block. The duration from the 1 st patient-controlled analgesia to bilateral TAP block recovery and postoperative 48 h patient controlled intravenousananlgesia compression numbers were recorded. The postoperative adverse reactions and discharge time were recorded. Results The mean time to request for postoperative analgesia was 4.60 h in the control group and 4.64,7.92,and 11.00 h in the 6.25,12.5,and 25 μg treatment groups,respectively.Conclusion Dexmedetomidine combined with ropivacaine under ultrasound-guided TAP block could improve the duration of postoperative analgesia as the dosage increases.

关 键 词：罗哌卡因 右美托嘧啶 腹横筋膜阻滞 辅剂 术后镇痛 

分 类 号：R45[医药卫生—治疗学]