左旋布比卡因复合右美托咪定骶管阻滞用于小儿术后镇痛的效果与不良反应研究  

Researches on the efficacy of levobupivacaine combined with dexmedetomidine for caudal block in children for postoperative analgesia and their adverse reactions

作　　者：张月顺 南锡浩 芦相玉 李颖 张艳丽 周旋 ZHANG Yueshun;NAN Xihao;LU Xiangyu;LI Ying;ZHANG Yanli;ZHOU Xuan(Department of Anesthesiology,Hongqi Hospital Affiliated to Mudanjiang Medical University,Mudanjiang157000,China;Department of Urology Surgery,Hongqi Hospital Affiliated to Mudanjiang Medical University,Mudanjiang157000,China)

机构地区：[1]牡丹江医学院附属红旗医院麻醉科,黑龙江牡丹江157000 [2]牡丹江医学院附属红旗医院泌尿外科,黑龙江牡丹江157000

出　　处：《中国现代医生》2020年第28期134-137,共4页China Modern Doctor

基　　金：黑龙江省牡丹江市科学技术计划项目(Z2017s0043)。

摘　　要：目的探讨左旋布比卡因复合右美托咪定骶管阻滞用于小儿术后镇痛效果及对不良反应的影响。方法选择2018年8月~2019年8月我院收治的86例下腹部和下肢手术患儿作为观察对象,将患儿随机分为对照组和观察组,每组各43例,对照组患儿选择0.25%的左旋布比卡因(注药容积1.00 mL/kg)注射行骶管阻滞,观察组患儿在对照组患儿的基础上加用右美托咪定(注药容积2.00μg/kg),观察两组患儿术后4、8、12、24 h的心率(HR)、平均动脉压(MAP)、镇痛、镇静评分和不良反应发生率。结果术后4、8、12 h观察组患者MAP及HR均低于对照组,差异有统计学意义(P<0.05),术后24 h两组患者MAP及HR比较,差异无统计学意义(P>0.05),观察组患者MAP及HR术后无明显变化(P>0.05),与对照组比较明显更稳定;术后4、8、12 h观察组患者FLACC评分明显低于对照组,Ramsay评分明显高于对照组,差异有统计学意义(P<0.05),术后24 h两组患者FLACC及Ramsay评分比较,差异无统计学意义(P>0.05);两组患儿术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论左旋布比卡因复合右美托咪定骶管阻滞用于小儿术后镇痛,效果明显优于单独使用左旋布比卡因,能够有效维持患儿循环系统的稳定,且不增加患儿不良反应发生率,具有较高的安全性。Objective To investigate the impacts of levobupivacaine combined with dexmedetomidine for caudal block in children for postoperative analgesia and their adverse reactions(ADRs).Methods From August 2018 to August 2019,a total of 86 children with lower abdomen and lower limb surgery admitted to our hospital were selected as the observation objects,and they were randomly divided into the control group(n=43)and the observation group(n=43).Children in the control group were given 0.25%levobupivacaine(injection volume 1.00 mL/kg)for caudal block,while children in the observation group were given dexmedetomidine(injection volume 2.00μg/kg).Meanwhile,the heart rate(HR),mean arterial pressure(MAP),analgesia,sedation scores and the incidence of ADRs were observed at 4,8,12 and 24 h after operation.Results At 4,8 and 12 h after operation,the MAP and HR in the observation group were lower than those in the control group,with statistically significant difference between the two groups(P<0.05).At 24 h after operation,there were no statistically significant differences between the two groups(P>0.05).While there were no obvious changes in MAP and HR in the observation group after operation(P>0.05),which was obviously more stable than those in the control group.At 4,8 and 12 h after operation,the FLACC scores of patients in the observation group were significantly lower than those in the control group,while Ramsay scores were significantly higher than those in the control group(P<0.05).At 24 h after operation,there was no statistically significant difference between the two groups in FLACC and Ramsay scores.There was no statistically significant difference between the two groups(P>0.05).There was no statistically significant difference in the incidence of postoperative ADRs between the two groups(P>0.05).Conclusion Levobupivacaine combined with dexmedetomidine for caudal block in children for postoperative analgesia is obviously superior to levobupivacaine alone,which effectively maintains the stability of children’s circulato

关 键 词：左旋布比卡因 右美托咪定 骶管阻滞 小儿术后镇痛效果 不良反应 

分 类 号：R614[医药卫生—麻醉学]