早期静脉泵注右美托咪定用于肋间神经阻滞麻醉临床观察  

Clinical Observation of Early Intravenous Pumping of Dexmedetomidine in Intercostal Nerve Block Anesthesia

作　　者：王韦玮[1] 朱建华[1] WANG Weiwei;ZHU Jianhua(The Second People's Hospital of Kunshan City,Suzhou,Jiangsu,China 215300)

机构地区：[1]江苏省昆山市第二人民医院,江苏苏州215300

出　　处：《中国药业》2022年第5期109-111,共3页China Pharmaceuticals

基　　金：江苏省昆山市社会发展科技专项[KS18082]。

摘　　要：目的探讨早期静脉泵注右美托咪定用于肋间神经阻滞麻醉的镇静、镇痛效果。方法选取医院2020年6月至8月收治的行单侧乳房肿块切除术患者60例,随机分为观察组和对照组,各30例。进入手术室后,观察组患者静脉泵注右美托咪定注射液,对照组患者静脉泵注0.9%氯化钠注射液,两组患者在超声引导下均于第2~5肋间予罗哌卡因注射液,每肋间5 mL,进行神经阻滞。结果与对照组比较,观察组患者在麻醉穿刺前(T_(1))、麻醉穿刺开始后1 min(T_(2))、手术开始切皮时(T_(3))的平均动脉压均显著降低,心率均显著减慢,Ramsay镇静量表评分均显著升高(P<0.05);T_(2)和T_(3)的视觉模拟评分法评分均显著降低,麻醉满意度评分均显著升高(P<0.05);观察组心动过缓发生率为20.00%,显著高于对照组的0(P<0.05)。结论早期静脉泵注右美托咪定具有一定的镇静、镇痛作用,可缓解患者对麻醉及手术的焦虑情绪,促进血流动力学指标平稳,提高患者对麻醉效果的满意度。Objective To investigate the sedative and analgesic effect of early intravenous pumping of dexmedetomidine in intercostal nerve block anesthesia.Methods A total of 60 patients who underwent unilateral mastectomy from June to August 2020 were selected and randomly divided into the observation group and the control group,with 30 cases in each group.After entering the operating room,the patients in the observation group were given the intravenous pumping of Dexmedetomidine Injection intravenously,while the patients in the control group were given the intravenous pumping of 0.9%Sodium Chloride Injection.Patients in both groups were given intercostal nerve blocks with Ropivacaine Injection(5 mL per rib)between the second and fifth ribs under the guidance of ultrasound.Results Compared with those in the control group,the mean arterial pressure(MAP)decreased significantly,the heart rate(HR)slow down significantly,and the Ramsay sedation scale(RSS)score increased significantly before anesthesia puncture(T_(1)),1 min after anesthesia puncture(T_(2))and at the beginning of skin incision(T_(3))in the observation group(P<0.05).Compared with those in the control group,the visual analogue scale(VAS)scores decreased significantly,while the score of anesthesia satisfaction increased significantly at T_(2) and T_(3) in the observation group(P<0.05).The incidence of bradycardia in the observation group was 20.00%,which was significantly higher than zero in the control group(P<0.05).Conclusion Early intravenous pumping of dexmedetomidine in intercostal nerve block anesthesia has a certain sedative and analgesic effect,which can reduce the patients'anxiety about anesthesia and surgery,promote the stability of hemodynamic indexes,and improve the patients'satisfaction with the anesthesia effect.

关 键 词：右美托咪定 肋间神经阻滞 镇静 镇痛 麻醉效果 

分 类 号：R969.4[医药卫生—药理学] R971[医药卫生—药学]