不同剂量右美托咪定复合罗哌卡因胸椎旁阻滞用于乳腺癌改良根治术术后镇痛的效果  

The postoperative analgesia effects of different doses of Dexmedetomidine with ropivacaine in thoracic paravertebral block for modified radical mastectomy in breast cancer

作　　者：袁炳林 黄锡强[2] 李斌飞[2] 黄焕森[3] YUAN Binglin;HUANG Xiqiang;LI Bingfei;HUANG Huansen(Graduate School of Guangzhou Medical University,Guangzhou 510200,China;Department of Anesthesiology,Zhongshan People's Hospital,Zhongshan 528400,China;不详)

机构地区：[1]广州医科大学研究生院,广州510200 [2]中山市人民医院麻醉科,广东中山528400 [3]广州医科大学附属第二医院麻醉科,广州510200

出　　处：《实用医学杂志》2021年第3期374-378,共5页The Journal of Practical Medicine

摘　　要：目的观察不同剂量右美托咪定(Dex)复合罗哌卡因胸椎旁阻滞用于乳腺癌改良根治术术后镇痛的效果。方法选择拟行乳腺癌改良根治术患者随机分成三组:Dex 1μg/kg+0.375%罗哌卡因20 mL(T_1组),Dex 1.5μg/kg+0.375%罗哌卡因20 mL(T_2组),0.375%罗哌卡因20 mL(C组)。记录阻滞起效时间及阻滞后感觉阻滞节段数、术中麻醉药物使用情况、术后视觉模拟评分、术后吗啡使用情况、术前及术毕血糖、超敏-C反应蛋白和并发症情况。结果T组阻滞起效时间比C组更快(P<0.05);阻滞后不同时段T组感觉阻滞节段数多于C组(P<0.05);T组术中麻醉药物用量少于C组(P<0.05);T组术后VAS评分低于C组(P<0.05);T组术后吗啡用量少于C组(P<0.05);T组术后血糖及超敏-C反应蛋白的变化幅度均低于C组(P<0.05);T_1组的并发症发生率最低(P<0.05)。结论Dex混合罗哌卡因胸椎旁阻滞用于乳腺癌根治术可增强术后镇痛的效果;Dex 1μg/kg组术后镇痛效果较好,不良反应更少。Objective This study observed the analgesic effect of dexmedetomidine(DEX)combined with ropivacaine for postoperative analgesia after modified radical mastectomy.Methods The patients were randomly divided into group T1,group T2 and group C.Group T1 was treated with 0.375%ropivacaine 20 mL plus Dex 1μg/kg,group T2 with 0.375%ropivacaine 20 mL plus Dex 1.5μg/kg and Group C with 0.375%ropivacaine20 mL.The onset time and the number of sensory block segments after anesthesia,the use of narcotic drugs during operation,postoperative visual analogue score,postoperative morphine use,blood glucose,high-sensitivity C-reactive protein and complications were recorded.Results The onset time of block in group T was faster than that in group C(P<0.05);the number of sensory block segments in group T was more than that in group C(P<0.05);the amount of anesthetic drugs used in group T was less than that in group C(P<0.05);the VAS score in group T was lower than that in group C(P<0.05);the dosage of morphine in group T was less than that in group C(P<0.05);the changes of blood glucose and high-sensitivity C-reactive protein in group T were lower than those in group C(P<0.05);the incidence of complications in group T1 was the lowest(P<0.05).Conclusion Thoracic paraspinal block with DEX and ropivacaine for radical mastectomy could enhance the effect of postoperative analgesia;thoracic paraspinal block with Dex lug/kg had better analgesic effect and fewer adverse reactions.

关 键 词：B超引导下胸椎旁阻滞 乳腺癌根治术 右美托咪定 罗哌卡因 镇痛强度 并发症 

分 类 号：R614.4[医药卫生—麻醉学]