右美托咪啶复合罗哌卡因超声引导腰方肌阻滞在剖宫产术后复合镇痛中的应用  

Application of Dexmedetomidine Combined with Ropivacaine in Ultrasound-guided Quadratus lumborum Block for Combined Analgesia after Cesarean Section

作　　者：熊冰 林爱红 XIONG Bing;LIN Ai-hong(Department of Anesthesiology,Luojiang District Majia Center Health hospital,Quanzhou 362000,China)

机构地区：[1]泉州市洛江区马甲中心卫生院麻醉科,福建泉州362000

出　　处：《海峡药学》2024年第5期86-88,共3页Strait Pharmaceutical Journal

摘　　要：目的探讨右美托咪啶复合罗哌卡因超声引导腰方肌阻滞在剖宫产术后复合镇痛中应用的可行性和有效性,为临床上选择安全有效的镇痛方式提供参考依据。方法80例拟在腰硬联合麻醉下行剖宫产手术的足月产妇,ASAⅠ~Ⅱ级,采用随机表法将所有产妇随机分为两组:对照组(C组)和观察组(T组),每组40例。C组产妇术后采用患者自控静脉镇痛(PCIA)。T组产妇术后先行右美托咪啶复合罗哌卡因超声引导双侧腰方肌阻滞后再行PCIA。观察和比较两组产妇术后4 h、8 h、12 h、24 h、48 h VAS疼痛评分,术后48 h内PCA按压次数、氟比洛芬酯补救剂量、不良反应发生情况和患者镇痛满意度评分。结果与C组相比,T组产妇术后4 h、8 h、12 h、24 h、48 h VAS疼痛评分均显著降低(P<0.05),术后48 h内自控镇痛按压次数、氟比洛芬酯补救剂量均显著减少(P<0.05),不良反应发生率显著降低(P<0.05),患者镇痛满意度评分显著升高(P<0.05)。结论右美托咪啶复合罗哌卡因超声引导腰方肌阻滞可安全有效地应用于剖宫产术后复合镇痛中,该镇痛方式在临床上具有一定的应用和推广价值。OBJECTIVE To investigate the feasibility and effectiveness of dexmedetomidine combined with ropivacaine in ultrasound-guided quadratus lumborum block for combined analgesia after cesarean section,and to provide reference for clinical selection of safe and effective analgesia.METHODS A total of 80 full-term parturients(ASAⅠ-Ⅱ)who planned to undergo cesarean section under combined epidural anesthesia were randomly divided into two groups by random table method:Control group(Group C)and Observation group(Group T),with 40 cases in each group.After operation,Group C was treated with PCIA.But Group T was treated with dexmedetomidine combined with ropivacaine in ultrasound-guided quadratus lumborum block followed by PCIA.The VAS scores at 4 h,8 h,12 h,24 h and 48 h after the operation were observed and compared between the two groups,as well as the number of PCA compression,flurbiprofen exate remedial dose,the occurrence of adverse reactions and the scores of patients′satisfaction with analgesia within 48 h after the operation.RESULTS Compared with Group C,the VAS score of Group T was significantly decreased at 4 h,8 h,12 h,24 h and 48 h after the operation(P<0.05),the number of PCA compression and flurbiprofen exate remedial dose were significantly decreased(P<0.05),and the incidence of adverse reactions was significantly decreased(P<0.05),the analgesic satisfaction scores were significantly increased(P<0.05)within 48 h after the operation.CONCLUSION Dexmedetomidine combined with ropivacaine in ultrasound-guided quadratus lumborum block for combined analgesia after cesarean section can be safely and effectively,and it has certain application and promotion value in clinic.

关 键 词：右美托咪啶 罗哌卡因 腰方肌阻滞 剖宫产 镇痛 

分 类 号：R969.4[医药卫生—药理学]