右美托咪定复合罗哌卡因用于连续股神经阻滞在全膝关节置换术后镇痛效果的观察  

Analgesic effects of dexmedetomidine combined with ropivacaine in continuous femoral nerve block after total knee arethroplasty

作　　者：代文涛[1] 席彪 刘娣 朱德浩[1] 王南海[1] DAI Wen-tao;XI Biao;LIU Di;ZHU De-hao;WANG Nan-hai(Department of Anesthesiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院麻醉科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2020年第4期482-485,共4页Journal of Bengbu Medical College

基　　金：蚌埠医学院科技发展基金项目(BYKF1781)。

摘　　要：目的:探讨右美托咪定复合罗哌卡因用于连续股神经阻滞在全膝关节置换术后的镇痛效果及不良反应。方法:选择60例应用连续股神经阻滞进行术后镇痛的全膝关节置换病人,随机分为2组,各30例。其中对照组(C组)镇痛药液配方0. 2%罗哌卡因;右美托咪定组(D组)在C组的基础上加用右美托咪定0. 1μg·kg^-1·h^-1。记录术前、术后镇痛治疗期间3、6、12、24、48 h各时间点的静息痛、运动痛和镇静的评分,术前、术后24、48 h各时间点的股四头肌肌力评分以及心动过缓,低血压,过度镇静等不良反应。结果:D组在术后6、12、24、48 h静息痛和运动痛的NRS评分均明显低于C组(P <0. 05~P <0. 01)。D组病人在术后各观察时间点的镇静评分均高于C组(P <0. 01)。D组病人低血压,心动过缓发生率也均明显高于C组(P <0. 05)。结论:右美托咪定复合罗哌卡因进行连续股神经阻滞可以增强镇痛效果,增加镇静效果,同时不影响股四头肌肌力,但在应用时需提防低血压,心动过缓等不良反应的发生。Objective:To investigate the analgesic effects and side effects of dexmetomidine combined with ropivacaine in continuous femoral nerve block after total knee arthroplasty.Methods:Sixty patients with continuous femoral nerve block analgesia after total knee arthroplasty were randomly divided into the control group(group C,30 cases)and dexmdetomidine group(group D,30 cases).The analgesic solution in group C and group D were 0.2%ropivacaine and 0.2%ropivacaine combined with 0.1μg·kg^-1·h^-1.dexmdetomidine,respectively.The scores of resting pain,motor pain and sedation in two groups were recorded before operation and after 3,6,12,24 and 48 h of operation.The scores of quadriceps femoris muscle strength were tested before surgery and after 24 h and 48 h of surgery,and the bradycardia,hypotension and excessive sedation of adverse reactions were observed in two groups.Results:The NRS scores of rest pain and motor pain in group D were significantly lower than those in group C at 6,12,24 and 48 hours after surgery(P<0.05 to P<0.01).The sedation scores in group D were higher than that in group C at all time-points after surgery(P<0.01).The incidence rates of hypotension and bradycardia in group D were significantly higher than those in group C(P<0.05).Conclusions:The dexmetomidine combined with ropivacaine in continuous femoral nerve block can enhance the analgesic effects and sedation effects,and dose not affect the muscle strength of quadriceps femoris.The hypotension and bradycardia of adverse reactions need to be prevented.

关 键 词：右美托咪定 连续股神经阻滞 镇痛 全膝关节置换术 

分 类 号：R971.2[医药卫生—药品]