右美托咪定作为罗哌卡因佐剂用于头皮神经阻滞的效果以及对血浆儿茶酚胺、内皮素-1的影响  

Effect of Dexmedetomidine as Ropivacaine Adjuvant on Scalp Nerve Block and its Effect on Plasma Catecholamine and Endostin-1

作　　者：郭庆聪 张曙[1] 袁淑贞 廖永强[1] 何炳华[1] 刘衬云[1] GUO Qing-cong;ZHANG Shu;YUAN Shu-zhen(Dongguan People’s Hospital,Dongguan,Guangdong,523000,China)

机构地区：[1]东莞市人民医院,广东东莞523000

出　　处：《黑龙江医学》2021年第1期51-53,56,共4页Heilongjiang Medical Journal

摘　　要：目的:探究开颅手术中右美托咪定作为罗哌卡因佐剂的阻滞的效果以及对血浆儿茶酚胺、内皮素-1(ET-1)的影响。方法:本次研究对象全部选自2018年3月-2019年11月期间在东莞市人民医院进行开颅手术的42例患者,按照不同的麻醉药物进行分组,其中21例使用0.9%氯化钠溶液的为对照组,21例使用罗哌卡因、右美托咪定的为实验组,分析比较两种方式对两侧头皮神经的阻滞效果。结果:实验组的术后24h内感觉阻滞时间多于对照组(P<0.05),两组的术后苏醒时间、麻醉时间差异无统计学意义(P>0.05);实验组和对照组术后1hVAS评分差异无统计学意义(P>0.05),两组术后6h、12h、18h、24h对比差异明显(P<0.05);实验组和对照组患者术后1h、6h、12hRamsay评分对比差异较显著(P<0.05),两组患者术后18h、24h对比差异无统计学意义(P>0.05);实验组和对照组麻醉诱导前的ET-1、去甲肾上腺素以及肾上腺素对比差异无统计学意义(P>0.05),两组术后6h、12h对比差异较明显(P<0.05);两组术后高血压发生率对比差异明显(P<0.05)。结论:右美托咪定作为罗哌卡因佐剂用于头皮神经阻滞的效果较好,不会升高ET-1和血浆儿茶酚胺。Objective:To investigate the blocking effect of dexmedetomidine as ropivacaine adjuvant in craniotomy and its effect on plasma catecholamines and et-1(ET-1).Methods:Selecting 42 patients from March,2018 to November,2019 in the hospital during the craniotomy surgery according to different anesthetic groups,including 21 cases using 0.9%sodium chloride solu-tion as the control group,and 21 cases using ROM pP because,right the microphones set as the experimental group.Two ways 0 scalp nerve block effect on both sides were compared.Results:The sensory block time of the experimental group was higher than that of the control group within 24 hours after operation(P<0.05),and the postoperative waking time and anesthesia time of the two groups were less different(P>0.05).VAS score 1 h after surgery showed little difference between the experimental group and the control group(P>0.05),while VAS score 6 h,12 h,18 h and 24 h after surgery showed significant difference between the two groups(P<0.05).There were significant differences in Ramsay scores between the experimental group and the control group 1 hour,6 hours and 12 hours after surgery(P<0.05),while there were small differences between the two groups 18 hours and 24 hours after surgery(P>0.05).The difference of ET-1,norepinephrine and epinephrine before anesthesia induction between the experimental group and the control group was little(P>0.05).The comparison of ET-1,norepinephrine and epinephrine before anesthesia induction between the two groups was significant(P<0.05).The incidence of postoperative hypertension was significantly diferent between the two groups(P<<0.05).Conclusion:Dexmedetomidine is effective as a ropivacaine adjuvant for scalp nerve block,and does not increase ET-1 and plasma catecholamine.

关 键 词：右美托咪定 罗哌卡因 佐剂 头皮神经阻滞 血浆儿茶酚胺 内皮素-1 

分 类 号：R614[医药卫生—麻醉学]