右美托咪定联合罗哌卡因行肋间神经阻滞对外耳再造患儿术后镇痛的效果分析  

Evaluation of analgesic effect of dexmedetomidine combined with ropivacaine for intercostal nerve block on postoperative analgesia in children undergoing external ear reconstruction

作　　者：陈春梅 邓晓明 郅娟 徐文莉 邢菲 王磊 Xu Wenli;Xing Fei;Wang Lei(Department of Anesthesiology,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院麻醉科,100144

出　　处：《北京医学》2021年第1期49-52,共4页Beijing Medical Journal

摘　　要：目的评价右美托咪定(dexmedetomidine, Dex)联合罗哌卡因行肋间神经阻滞对肋软骨移植外耳再造患儿手术后的镇痛效果。方法选取2019年6月至2020年1月中国医学科学院北京协和医学院整形外科医院80例择期行肋软骨移植外耳再造患儿,随机分为单纯罗哌卡因组(A组)和Dex联合罗哌卡因组(B组),每组40例。比较两组术后1、4、6、8、12、24、48 h时静息、咳嗽状态的疼痛数字量表(numerical rating scale, NRS)评分、Ramsay评分、术后镇痛持续时间、口服镇痛药的次数及不良反应发生情况。结果 B组术后1、4、6、8、12 h的静息、咳嗽状态NRS评分均低于A组(P <0.05),Ramsay评分大于A组(P <0.05),而两组静息、咳嗽状态NRS评分及Ramsay评分在术后24 h和48 h时的比较,差异均无统计学意义(P> 0.05);B组镇痛持续时间长于A组[(714±78)min比(378±86)min, P <0.05];B组口服镇痛药的次数少于A组[(1.13±0.72)次比(0.60±0.55)次,P <0.05];两组不良反应的发生情况比较,差异无统计学意义(P>0.05)。结论 Dex联合罗哌卡因行肋间神经阻滞能增强外耳再造患儿的术后镇静镇痛效果,减少辅助镇痛药的使用,延长镇痛持续时间且不增加不良反应的发生率。Objective To evaluate the analgesic effect of dexmedetomidine(Dex) combined with ropivacaine for intercostal nerve block in children undergoing external ear reconstruction with costal cartilage. Methods Eighty children who underwent selective ear reconstruction with costal cartilage were randomly assigned into two groups from June 2019 to January 2020, 40 cases in each group, ropivacaine group(group A) and Dex combined with ropivacaine group(group B). Resting and coughing numerical rating scale(NRS) scores, Ramsay scores at 1, 4, 6, 8, 12, 24, 48 h were compared,the duration of postoperative analgesia, the number of oral analgesics used and the incidence of side effects were also compared between the two groups. Results The resting and coughing NRS scores in group B at 1, 4, 6, 8, 12 h after surgery were lower than those in group A(P < 0.05), and Ramsay scores were higher than those in group A(P < 0.05), while there were no significant differences in the resting and coughing NRS scores as well as Ramsay scores between the two groups at 24 h and 48 h after surgery(P > 0.05). The duration of analgesia in group B was longer than that in group A [(714 ± 78) min vs.(378 ± 86) min, P <0.05]. The times of oral analgesics in group B was less than that in group A [(1.13 ± 0.72) times vs.(0.60 ± 0.55) times, P <0.05]. There was no significant differences in the incidences of side effects between the two groups(P > 0.05). Conclusions Dex combined with ropivacaine for intercostal nerve block can enhance the postoperative sedative and analgesic effects in children undergoing ear reconstruction, reduce the use of oral analgesics, extend the duration of analgesia without increasing the incidence of side effects.

关 键 词：右美托咪定 肋间神经阻滞 外耳再造术 镇静 镇痛 儿童 

分 类 号：R726.1[医药卫生—儿科]