右美托咪定复合罗哌卡因腹横肌平面阻滞对腹腔镜下腹股沟斜疝高位结扎术患儿血流动力学及麻醉质量的影响研究  

Effects of dexmedetomidine combined with ropivacaine on the transverse hemifacial plane block on hemodynamics and anesthesia quality in children undergoing high ligation of inguinal hernia

作　　者：刘明[1] 常红侠[1] LIU Ming;CHANG Hongxia.(Department of Anesthesiology,Shangluo Central Hospital in Shaanxi Province(Shangluo 726000))

机构地区：[1]陕西省商洛市中心医院麻醉科

出　　处：《陕西医学杂志》2019年第10期1268-1271,共4页Shaanxi Medical Journal

基　　金：国家自然科学基金资助面上项目(81271343)

摘　　要：目的:探讨右美托咪定复合罗哌卡因腹横肌平面阻滞(TAPB)对腹腔镜下腹股沟斜疝(IIH)高位结扎术患儿麻醉质量及血流动力学的影响。方法:计算机形成随机数列分组法将132例IIH患儿分为两组。对照组TAPB使用0.25%的罗哌卡因;观察组使用0.25%的罗哌卡因+1μg/kg的右美托咪定。对比两组TAPB起效时间、麻醉后监测治疗室(PACU)停留时间、持续镇痛时间、术后不同时期FLACC量表评分及不良反应发生情况。测定两组在TAPB前、切皮后、术毕时平均动脉压(MAP)和心率(HR)。结果:与对照组比,观察组TAPB起效时间明显缩短,持续镇痛时间显著延长,术后1、3、6、12h时FLACC评分低(P<0.05)。对照组MAP、HR在TAPB前、切皮后、术毕时出现明显波动(P<0.05);观察组波动不明显(P>0.05)。两组PACU停留时间和术后不良反应发生率间差异无统计学意义(P>0.05)。结论:右美托咪定与罗哌卡因联合应用于IIH患儿疝囊高位结扎中,可有效缩短麻醉起效时间,维持术中血流动力学稳定,术后镇痛时间持久,安全性高。Objective:To investigate the effects of dexmedetomidine combined with ropivacaine for transverse abdominis plane block(TAPB)on anesthesia quality and hemodynamics in children with high ligation of laparoscopic inguinal hernia(IIH).Methods:132 patients with IIH were divided into two groups by computer-generated random number grouping.The TAPB of the control group was used 0.25%ropivacaine;and the observation group was used 0.25%ropivacaine+1μg/kg dexmedetomidine.The onset time of TAPB,the duration of post-anesthesia monitoring and treatment(PACU),the duration of analgesia,the score of FLACC scale and the incidence of adverse reactions at different postoperative periods were compared between two group.Mean arterial pressure(MAP)and heart rate(HR)were measured before TAPB,after cut leather,and at the end of surgery in the two groups.Results:Compared with the control group,the onset time of TABP was significantly shortened in the observation group,the duration of continuous analgesia was significantly prolonged,and the FLACC score was low at 1 h,3 h,6 h,and 12 h after operation(P<0.05).The MAP and HR of the control group showed significant fluctuations before TAPB,after cut leather,and at the end of surgery(P<0.05),and the fluctuation of the observation group was not obvious(P>0.05).There was no significant difference in the duration of PACU between the two groups and the incidence of postoperative adverse reactions(P>0.05).Conclusion:The combination of dexmedetomidine and ropivacaine in the high ligation of the hernia sac in children with IIH can effectively shorten the onset time of anesthesia,maintain hemodynamic stability during operation,prolong postoperative analgesia,and have high safety.

关 键 词：腹股沟疝 手术疗法 腹横肌平面阻滞 罗哌卡因 右美托咪定 麻醉质量 血流动力学 

分 类 号：R656.21[医药卫生—外科学]