右美托咪啶复合局麻药TAPB对子宫切除患者影响  

The effect of Dexmedetomidine combined with local Anesthetic TAPB on Patients undergoing Hysterectomy

作　　者：张立俊 郭国建 ZHANG Lijun;GUO Guojian(Department of Anesthesiology,Pingdingshan Maternal and Child Health Hospital,Pingdingshan Henan 467000,China)

机构地区：[1]平顶山市妇幼保健院麻醉科,河南平顶山467000

出　　处：《临床研究》2023年第11期73-76,共4页Clinical Research

摘　　要：目的 探讨在子宫切除患者中应用右美托咪定复合局麻药腹横肌平面阻滞(TAPB)的镇痛效果及对患者应激反应的影响。方法 选取2019年3月至2022年3月平顶山市妇幼保健院妇科收治的拟行子宫切除术的86例患者为对象,根据术中注射药物将其分为对照组、试验组。两组均经气管插管麻醉诱导后行TAPB子宫切除,对照组采用罗哌卡因实施局部麻醉,试验组采用右美托咪复合罗哌卡因实施局部麻醉。比较两组术后首次疼痛时间、自主呼吸恢复时间、唤醒时间、拔管时间。比较两组镇痛开始时刻(T_(0))、术后拔管时(T_(1))、术后6 h(T_(2))疼痛程度、镇静程度、应激因子水平,并比较两组不良反应发生情况。结果 试验组术后首次疼痛时间晚于对照组,自主呼吸恢复时间、唤醒时间、拔管时间早于对照组,差异有统计学意义(P<0.05);T_(1)、T_(2)时试验组疼痛、镇静评分均低于对照组,差异有统计学意义(P<0.05);两组皮质醇、去甲肾上腺素水平随时间延长而升高,且试验组低于对照组,差异有统计学意义(P<0.05);T_(1)、T_(2)时试验组收缩压、舒张压、心率低于对照组,差异有统计学意义(P<0.05);试验组不良反应发生率8.70%,对照组15.00%,两组差异无统计学意义(P>0.05)。结论 对实施子宫切除术患者给予右美托咪定复合局麻药行TAPB,可有效改善镇痛效果,降低应激因子水平,缓解应激反应,不良反应发生率低,安全性佳。Objective To investigate the analgesic effect of dexmedetomidine combined with local anesthetic abdominal transverse plane block (TAPB) in patients undergoing hysterectomy and its impact on the patient's stress response.Methods A total of 86 patients who were admitted to the gynecology department of Pingdingshan Maternal and Child Health Hospital from March 2019 to March 2022 and planned to undergo hysterectomy were selected as the subjects.They were divided into a control group and an experimental group based on intraoperative drug injection.Both groups underwent TAPB hysterectomy after induction of tracheal intubation anesthesia.The control group received local anesthesia with ropivacaine,while the experimental group received local anesthesia with dexmedetomidine combined with ropivacaine.The first postoperative pain time,spontaneous breathing recovery time,awakening time,and extubation time between the two groups were compared.The onset of analgesic(T_(0)),postoperative extubation (T_(1)),and pain level 6 hours after operation,sedation level,and stress factor levels between the two groups were compared,and the occurrence of adverse reactions between the two groups were compared.Results The first postoperative pain time in the experimental group was later than that in the control group,and the recovery time,awakening time,and extubation time of spontaneous respiration were earlier than those in the control group,with statistically significant differences(P<0.05);At T_(1) and T_(2),the pain and sedation scores of the experimental group were lower than those of the control group,with statistically significant differences (P<0.05);The levels of cortisol and norepinephrine in the two groups increased with time,and the experimental group was lower than the control group,with a statistically significant difference (P<0.05);At T_(1) and T_(2),the systolic blood pressure,diastolic blood pressure,and heart rate in the experimental group were lower than those in the control group,with statistically significant difference

关 键 词：右美托咪定 局麻药 子宫切除术 镇痛效果 应激反应 

分 类 号：R713.42[医药卫生—妇产科学]