右美托咪定复合罗哌卡因联合后路腰方肌阻滞在腹腔镜全子宫切除术中的应用  

Application of Dexmedetomidine Combined with Ropivacaine and Quadra⁃tus Lumborum Block in Laparoscopic Total Hysterectomy

作　　者：顾晓灵 钱斌 GU Xiaoling;QIAN Bin(Department of Anesthesiology,Yancheng First People's Hospital(Affiliated to Nanjing University School of Medicine Yancheng First Hospital),Yancheng 224005,Jiangsu,China)

机构地区：[1]盐城市第一人民医院(南京大学医学院附属盐城第一医院)麻醉科,江苏盐城224005

出　　处：《中外医疗》2024年第22期5-8,共4页China & Foreign Medical Treatment

基　　金：盐城市卫健委2023年度医学科研立项面上项目(YK2023048)。

摘　　要：目的探究在腹腔镜全子宫切除术中结合右美托咪定、罗哌卡因进行后路腰方肌阻滞的效果。方法方便选取2023年2—12月盐城市第一人民医院收治的104例行腹腔镜全子宫切除术患者作为研究对象,根据不同麻醉方法分为两组,各52例。两组均在麻醉诱导前行双侧后路腰方肌阻滞,其中对照组注射罗哌卡因,观察组注射右美托咪啶复合罗哌卡因。对比两组血流动力学指标、疼痛程度、应激指标。结果两组麻醉前(T1)、手术30 min(T2)、术后6 h(T3)的平均动脉压和心率对比,差异无统计学意义(P均>0.05);观察组T3、术后12 h(T4)、术后24 h(T5)、术后48 h(T6)的疼痛程度评分分别为(0.96±0.31)分、(1.12±0.28)分、(1.26±0.32)分、(1.52±0.47)分,均低于对照组的(1.22±0.26)分、(1.49±0.35)分、(1.62±0.35)分和(2.06±0.52)分,差异有统计学意义(t=4.634、5.953、5.474、5.555,P均<0.05);两组T1、T2、T5、T6的应激反应指标对比,差异无统计学意义(P均>0.05)。结论对进行后路腰方肌阻滞的腹腔镜全子宫切除术患者应用右美托咪定、罗哌卡因,临床效果更优,对患者的生理状态影响较轻。Objective To analyze the application effect of dexmedetomidine combined with ropivacaine and quadratus lumborum block in laparoscopic total hysterectomy.Methods A total of 104 patients undergoing laparoscopic total hysterectomy admitted to Yancheng First People's Hospital from February to December 2023 were conveniently selected as the research objects.They were divided into two groups by different anesthesia methods,with 52 cases in each group.Both groups were given bilateral posterior quadratus lumborum block before anesthesia induction.The control group was injected with ropivacaine,and the observation group was injected with dexmedetomidine combined with ropivacaine.The hemodynamic index,pain degree,stress index of the two groups were compared.Results There was no significant difference in mean arterial pressure and heart rate between the two groups before anesthesia(T1),operation 30 min(T2)and 6 h after operation(T3)(all P>0.05).The pain scores of the observation group at T3,12 h after operation(T4),24 h after operation(T5)and 48 h after operation(T6)were(0.96±0.31)points,(1.12±0.28)points,(1.26±0.32)points and(1.52±0.47)points,respectively,which were lower than those of the control group(1.22±0.26)points,(1.49±0.35)points,(1.62±0.35)points and(2.06±0.52)points,and the differences were statistically significant(t=4.634,5.953,5.474,5.555,all P<0.05).There was no significant difference in stress response indexes between the two groups at T1,T2,T5 and T6(all P>0.05).Conclusion The application of dexmedetomidine and ropivacaine in patients undergoing laparoscopic total hysterectomy with quadratus lumborum block has better clinical effect and less influence on the physiological state of patients.

关 键 词：腹腔镜全子宫切除术 右美托咪定 罗哌卡因 后路腰方肌阻滞 血流动力学指标 疼痛程度 

分 类 号：R614[医药卫生—麻醉学]