甲磺酸罗哌卡因与盐酸罗哌卡因分别复合右美托咪定股神经-坐骨神经阻滞在胫腓骨骨折内固定术的应用比较  

Comparison of ropivacaine mesylate and ropivacaine hydrochloride combined with dexmedetomidine femoral nerve-sciatic nerve block in internal fixation of tibiofibular fractures

作　　者：王朝阳 唐楠[1] 杜平均 杨红亮 高学锋 WANG Chaoyang;TANG Nan;DU Pingjun;YANG Hongliang;GAO Xuefeng(Anesthesiology Department,The seventh People's Hospital of Hebei Province(Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine),Dingzhou 073000,China)

机构地区：[1]河北省第七人民医院(河北中医学院第二附属医院)麻醉科,河北省定州市073000

出　　处：《中国煤炭工业医学杂志》2024年第1期23-27,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省卫生健康委重点科技研究计划(编号:20190778)。

摘　　要：目的探讨甲磺酸罗哌卡因与盐酸罗哌卡因分别复合右美托咪定实施股神经-坐骨神经阻滞在胫腓骨骨折内固定术的应用效果。方法选取2019年10月—2022年3月河北省第七人民医院收治的拟行内固定术治疗的134例胫腓骨骨折患者为研究对象,采用随机数字表法分为A、B二组,每组67例。A组行注射甲磺酸罗哌卡因复合右美托咪定股神经-坐骨神经阻滞,B组行注射盐酸罗哌卡因复合右美托咪定股神经-坐骨神经阻滞。比较二组患者运动、感觉阻滞起效、维持时间以及镇痛效果,对比二组患者麻醉前、手术30min、手术结束时心率(HR)、平均动脉压(MAP)以及不良反应发生率。结果B组运动、感觉阻滞起效时间短于A组(P<0.05),运动、感觉阻滞维持时间长于A组(P<0.05);二组术后6h、24h、48h时VAS评分比较差异无统计学意义(P>0.05),二组术后6h、12h、24h、48h时VAS评分均依次升高(P<0.05),B组术后12h的VAS评分低于A组(P<0.05),二组PCIA有效按压次数比较差异无统计学意义(P>0.05);二组患者麻醉前、手术30min、手术结束时的HR、MAP以及术后不良反应发生率比较,差异无统计意义(P>0.05)。结论胫腓骨骨折内固定术采用甲磺酸罗哌卡因复合右美托咪定和盐酸罗哌卡因复合右美托咪定实施股神经-坐骨神经阻滞,两者的镇痛效果和安全性均相当,但盐酸罗哌卡因复合右美托咪定起效更快且镇痛持续时间更长。Objective To investigate the application effect of femoral nerve-sciatic nerve block and ropivacaine mesylate and ropivacaine hydrochloride combined with dexmedetomidine in internal fixation of tibiofibular fracture.Methods One hundred and thirty-four patients with tibiofibular fractures who were admitted to the Seventh People's Hospital of Hebei Province from October 2019 to March 2022 and planned to undergo internal fixation surgery were selected as the research subjects.They were randomly divided into group A and group B,with 67 cases in each group.Group A was injected with ropivacaine mesylate combined with dexmedetomidine for femoral nerve-sciatic nerve block,and group B was injected with ropivacaine hydrochloride combined with dexmedetomidine for femoral nerve-sciatic nerve block.The onset,maintenance time and analgesic effect of motor and sensory block were compared between the two groups,and the heart rate(HR),mean arterial pressure(MAP)before anesthesia,30 minutes after operation and at the end of operation and the incidence of adverse reactions were compared between the two groups.Results The onset time of motor and sensory block in group B were shorter than those in group A(P<0.05),and the maintenance time of motor and sensory block were longer than those in group A(P<0.05).There was no significant difference in VAS scores between the two groups at 6h,24h and 48h after operation(P>0.05).The VAS scores of the two groups increased successively at 6h,12h,24h and 48h after operation(P<0.05).The VAS score of group B was lower than that of group A at 12h after operation(P<0.05).There was no statistically significant difference in the number of effective compressions between the two groups of PCIA(P>0.05).There were no statistical significances in HR and MAP before anesthesia,30 minutes after operation and at the end of operation,and the incidence of postoperative adverse reactions between two groups(P>0.05).Conclusion Ropivacaine mesylate combined with dexmedetomidine and ropivacaine hydrochloride combined w

关 键 词：胫腓骨骨折 内固定术 股神经-坐骨神经阻滞 甲磺酸罗哌卡因 盐酸罗哌卡因 

分 类 号：R971.2[医药卫生—药品]