右美托咪定及瑞芬太尼复合腹直肌鞘神经阻滞在腹膜透析管植入术中的应用效果  

Effect of Dexmedetomidine and Remifentanil combined with Abdominis Rectus Sheath Nerve Block in Peritoneal Dialysis Tube Implantation

作　　者：张莹[1] ZHANG Ying(Department of Anesthesiology,Suzhou Jiulong Hospital,School of Medicine,Shanghai Jiao Tong University,,Suzhou 215000,China)

机构地区：[1]上海交通大学医学院附属苏州九龙医院麻醉科,江苏苏州215000

出　　处：《中国药物经济学》2023年第12期78-82,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨右美托咪定及瑞芬太尼复合腹直肌鞘神经阻滞在腹膜透析管植入术中的应用效果。方法选取2020年2月至2022年12月上海交通大学医学院附属苏州九龙医院收治的70例行腹膜透析管植入术的终末期肾病患者作为研究对象,按照随机数字表法分为观察组与对照组,每组35例。对照组予以常规腹直肌鞘神经阻滞,观察组采用右美托咪定及瑞芬太尼复合腹直肌鞘神经阻滞。比较两组患者麻醉效果,基础值(T_(1))、手术开始即刻(T_(2))、手术开始后20 min(T_(3))、手术结束即刻(T_(4))的生命体征变化情况,麻醉药用量与苏醒指标,术后2、6、12、24 h的视觉模拟评分法(VAS)评分以及不良反应情况。结果观察组麻醉优良率明显高于对照组(P<0.05);T_(1)~T_(4)时观察组血氧饱和度(SpO_(2))、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)比较差异无统计学意义(P>0.05),对照组T_(1)~T_(4)时SpO_(2)、HR、MAP、DBP、SBP比较差异有统计学意义(P<0.05),T_(2)和T_(3)时观察组与对照组SpO_(2)、HR、MAP、DBP、SBP比较差异有统计学意义(P<0.05);观察组术中丙泊酚用量、睁眼时间、自主呼吸恢复时间、麻醉恢复室(PACU)停留时间均明显低于对照组(P<0.05);观察组术后2、6、12、24 h的VAS评分明显低于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论右美托咪定及瑞芬太尼复合腹横肌平面阻滞能够提升终末期肾病患者在腹膜透析管植入术中的麻醉效果,稳定患者生命体征,减少麻醉药用量,提升苏醒质量,同时该麻醉方式还能够进一步减轻患者术后疼痛程度,且安全性较高。Objective To explore the effect of dexmedetomidine and remifentanil combined with abdominis rectus sheath nerve block in peritoneal dialysis tube implantation.Methods Seventy patients with end-stage renal disease who underwent peritoneal dialysis tube implantation in Suzhou Jiulong Hospital affiliated to Shanghai Jiao Tong University School of Medicine from February 2020 to December 2022 were selected as the study objects,and were divided into observation group and control group according to random number table method,with 35 cases in each group.The control group was given conventional rectus sheath nerve block,while the observation group was given dexmedetomidine and remifentanil combined with rectus sheath nerve block.The anesthetic effects,vital signs changes in basic value(T_(1)),vital signs immediately after the operation(T_(2)),20 minutes after the operation(T_(3)),and immediately after the operation(T_(4)),as well as anesthetic dosage and recovery indexes,visual analogue scale(VAS)scores at 2,6,12 and 24 h after surgery and adverse reactions of the two groups were compared.Results The excellent and good rate of anesthesia in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in blood oxygen saturation(SpO_(2)),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)and heart rate(HR)between T_(1) and T_(4)(P>0.05).There were statistically significant differences in SpO_(2),HR,MAP,DBP and SBP between T_(1) and T_(4) in control group(P<0.05),and there were statistically significant differences in SpO_(2),HR,MAP,DBP and SBP between observation group and control group at T_(2) and T_(3)(P<0.05).The intraoperative propofol dosage,eye opening time,spontaneous breathing recovery time and PACU stay time in the observation group were significantly lower than those in the control group (P<0.05). VAS scores of the observation group at 2, 6, 12 and 24 h after surgery were significantly lower than those of the control g

关 键 词：右美托咪定 瑞芬太尼 腹直肌鞘神经阻滞 腹膜透析管植入术 生命体征 不良反应 

分 类 号：R692.5[医药卫生—泌尿科学] R971[医药卫生—外科学]