胸腔镜手术麻醉诱导前行超声引导下小剂量右美托咪定复合罗哌卡因胸椎旁阻滞的实施效果  

The effect of ultrasound-guided low-dose dexmedetomidine combined with ropivacaine thoracic paravertebral block was performed before anesthesia induction in thoracoscopic surgery

作　　者：王清兵[1] 司兴艳[1] 王晓芳[1] WANG Qingbing;SI Xingyan;WANG Xiaofang(Department of Anesthesiology,Binzhou Central Hospital,Binzhou,Shandong,251700,China)

机构地区：[1]滨州市中心医院麻醉科,山东滨州251700

出　　处：《当代医学》2024年第2期137-140,共4页Contemporary Medicine

摘　　要：目的探讨胸腔镜手术麻醉诱导前行超声引导下小剂量右美托咪定复合罗哌卡因胸椎旁阻滞的实施效果。方法选取2021年1—12月滨州市中心医院收治的80例胸腔镜手术患者作为研究对象,随机分为对照组与观察组,每组40例。对照组麻醉诱导前应用罗哌卡因进行胸椎旁阻滞,观察组应用小剂量右美托咪定复合罗哌卡因进行胸椎旁阻滞。比较两组不同时间点血流动力学指标、麻醉相关时间、麻醉药物使用剂量及不良反应发生情况。结果气管插管时、切皮时、手术结束时,观察组平均动脉压(MAP)、心率(HR)水平均低于对照组,差异有统计学意义(P<0.05)。观察组阻滞起效时间、阻滞平面固定时间均短于对照组,差异有统计学意义(P<0.05);两组复苏室停留时间比较差异无统计学意义。观察组七氟烷、瑞芬太尼用量均少于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为2.50%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论行胸腔镜手术时,以超声诱导行小剂量右美托咪定复合罗哌卡因胸椎旁阻滞后再开展麻醉诱导,阻滞效果理想,且安全性良好。Objective To explore the effect of ultrasound-guided low-dose dexmedetomidine combined with ropivacaine thoracic paravertebral block was performed before anesthesia induction in thoracoscopic surgery.Methods 80 patients with thoracoscopic surgery treated in Binzhou Central Hospital from January to December 2021 were selected as the research subjects,and they were randomly divided into the control group and the observation group,with 40 cases in each group.The control group received thoracic paravertebral block with ropivacaine before anesthesia induction,and the observation group received thoracic paravertebral block with low-dose dexmedetomidine combined with ropivacaine.The hemodynamic indexes,anesthesia related time,anesthetic drug dosage and the occurrence of adverse reactions were compared between the two groups at different time points.Results The mean arterial pressure(MAP)and heart rate(HR)levels in the observation group were lower than those in the control group at the time of endotracheal intubation,skin incision and the end of operation,and the differences were statistically significant(P<0.05).The onset time and fixation time of block plane in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in residence time of resuscitation room between the two groups.The dosage of sevoflurane and remifentanil in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 2.50%,which was lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion In thoracoscopic surgery,after low-dose dexmedetomidine combined with ropivacaine paravertebral block induced by ultrasound,anesthesia induction is carried out,the blocking effect is ideal and the safety is good.

关 键 词：胸腔镜手术 右美托咪定 胸椎旁阻滞 

分 类 号：R614[医药卫生—麻醉学]