右美托咪定复合罗哌卡因腹横肌平面阻滞对腹腔镜卵巢囊肿切除术术后镇痛效果  

Analgesia effect of dexmedetomidine combined with ropivacaine transversus abdominals plane block after laparoscopic ovarian cyst resection

作　　者：赵传成 张景超 张祥飞 ZHAO Chuancheng;ZHANG Jingchao;ZHANG Xiangfei(The First People's Hospital of Suzhou,Anhui Province,234000)

机构地区：[1]安徽省宿州市第一人民医院,234000

出　　处：《中国计划生育学杂志》2021年第3期478-481,共4页Chinese Journal of Family Planning

基　　金：安徽省宿州市科技计划项目(SZ2017GG48)。

摘　　要：目的:探究右美托咪定(Dex)复合罗哌卡因腹横肌平面阻滞对腹腔镜卵巢囊肿切除术术后镇痛的效果。方法:选取2018年1月—2020年10月本院收治的拟行腹腔镜卵巢囊肿切除术患者94例,随机数字表法分为Dex组与对照组,两组均行全麻,手术结束时行超声引导下腹横肌平面阻滞,Dex组腹横肌平面内注射Dex 0.5μg/kg+0.25%罗哌卡因40ml,对照组注射0.25%罗哌卡因40ml,对比两组血流动力学指标、疼痛评分、镇痛效果及不良反应。结果:两组术中及术后各时间点血压及心率均无差异(P>0.05);术后6h、12h时Dex组VAS评分(1.18±0.56分、1.70±0.61分)均低于对照组,自控镇痛有效按压次数(5.3±1.7次)、苏醒时间(3.2±0.6min)、自主呼吸恢复时间(3.7±0.9 min)及拔除喉罩时间(4.3±0.8 min)均短于对照组,首次按压镇痛泵时间(21.5±7.7h)及感觉阻滞时间(8.4±1.5h)均长于对照组,术后24h芬太尼(362.78±103.42μg)及异丙酚(65.76±16.30g/kg/min)药量均少于对照组(P<0.05),不良反应总发生率(8.5%)与对照组无差异(12.8%)(P>0.05)。结论:Dex复合罗哌卡因腹横肌平面阻滞可提高腹腔镜卵巢囊肿切除术术后镇痛效果,延长镇痛时间,利于术后苏醒。Objective:To investigate the postoperative analgesic effect of dexmedetomidine(Dex)combined with ropivacaine transversus abdominals plane block of laparoscopic ovarian cyst resection.Methods:From January 2018 to October 2020,94 women who had undergone laparoscopic ovarian cyst resection were selected and were divided into study group and control group according to the random number table.All of the women had received general anesthesia,and ultrasound-guided transverse abdominals plane block was performed at the end of the operation.The women in the study group were injected into the transverse abdominal muscle with 40 ml of Dex 0.5μg/kg combined with 0.25%ropivacaine,and the women in the control group were injected into the transverse abdominal muscle with 40 ml of 0.25%ropivacaine only.The hemodynamic indexes,pain score,analgesic effect,and adverse reactions rate of the women were compared between the two groups.Results:There were no significant differences in blood pressure value and heart rate of the women between the two groups during and after operation(P>0.05).VAS score of the women in the study group at postoperative 6 h,12 h were 1.18±0.56 points and 1.70±0.61 points,which were significant lower than those of the women in the control group.The pressure times by self-control effective analgesia(5.3±1.7 times),awakening time(3.2±0.6 min),spontaneous breathing recovery time(3.7±0.9 min),and the extubation time of laryngeal mask(4.3±0.8 min)of the women in the study group were significant less than those of the women in the control group,but the time of analgesia pump pressed for the first time(21.5±7.7 h)and the time of sensory blockade(8.4±1.5 h)of the women in the study group were significant longer.The dosage of fentanyl used(362.78±103.42μg)and propofol used(65.76±16.30 g/kg/min)of the women in the study group at 24 h after surgery were significant less than those of the women in the control group(P<0.05),and the total incidence of adverse reactions(8.5%)of the women in the study group had no

关 键 词：腹腔镜卵巢囊肿切除术 术后镇痛 右美托咪定 罗哌卡因 腹横肌平面阻滞 

分 类 号：R614[医药卫生—麻醉学] R737.31[医药卫生—外科学]