右美托咪定复合罗哌卡因胸椎旁神经阻滞在单侧开胸手术后的镇痛效果  

Analgesic effect of dexmedetomidine combined with ropivacaine in thoracic paravertebral nerve block after unilateral thoracotomy

作　　者：骆僡 任颖[1] 王文君 LUO Hui;REN Ying;WANG Wenjun(Department of Anesthesiology,Liangxiang Hospital,Fangshan District,Beijing 102401,China)

机构地区：[1]北京市房山区良乡医院麻醉科,102401

出　　处：《临床合理用药杂志》2020年第26期12-13,29,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察右美托咪定复合罗哌卡因胸椎旁神经阻滞在单侧开胸手术后的镇痛效果。方法选取2018年1月-2019年1月北京市房山区良乡医院收治的单侧开胸手术患者76例为研究对象,采取随机数字表法分为联合组和对照组,每组38例。患者均行胸椎旁神经阻滞,对照组给予罗哌卡因麻醉,联合组在对照组基础上给予右美托咪定麻醉,比较2组术后不同时间视觉模拟疼痛评分(VAS)、追加药物情况及不良反应。结果2组术后1、4 h VAS评分比较差异无统计学意义(P>0.05),联合组术后12、24、48 h VAS评分均低于对照组(P<0.05或P<0.01);联合组追加咪达唑仑、吗啡患者例数占比及不良反应发生率均低于对照组,差异有统计学意义(P<0.01)。结论右美托咪定复合罗哌卡因胸椎旁神经阻滞在单侧开胸手术中具有良好镇痛效果,可有效缓解患者术后疼痛感,减少药物追加,同时还可降低不良反应发生率,预后良好,值得临床推广应用。Objective To investigate the analgesic effect of dexmedetomidine combined with ropivacaine in thoracic paravertebral nerve block after unilateral thoracotomy.Methods A total of 76 cases of unilateral thoracotomy patients in Liangxiang Hospital of Fangshan District from January 2018 to January 2019 were studied and randomly divided into the combined group and the control group with 38 cases each.All patients received thoracic paravertebral nerve block.The control group was given ropivacaine,and the combined group was given dexmedetomidine on the basis of the control group.The visual analogue scale(VAS),additional drugs and adverse reactions were compared between the two groups at different times after surgery.Results There was no significant difference in VAS scores between the two groups at 1,4 hours after operation(P>0.05).The VAS scores of the combined group were lower than those of the control group at 12,24,and 48 hours after operation(P<0.05 or P<0.01).The proportion of patients with midazolam and morphine and the incidence of adverse reactions in the combination group were lower than those in the control group,and the difference was statistically significant(P<0.01).Conclusion Dexmedetomidine combined with ropivacaine thoracic paravertebral nerve block has a good analgesic effect in unilateral thoracotomy,which can effectively alleviate postoperative pain in patients,reduce additional drugs,and reduce the incidence of adverse reactions.The prognosis is good and it is worthy of clinical application.

关 键 词：单侧开胸手术 右美托咪定 罗哌卡因 胸椎旁神经阻滞 镇痛效果 

分 类 号：R614[医药卫生—麻醉学]