右美托咪定联合罗哌卡因TAPB麻醉对药物成瘾患者苏醒的影响  

Effects of dexmedetomidine combines with ropivacaine TAPB anesthesia on the awakening of drug-addicted patients

作　　者：罗玲[1] 单家媛[1] 杨州旭 杨洪涛 LUO Ling;SHAN Jiayuan;YANG Zhouxu;YANG Hongtao(The First People's Hospital of Liangshan Yi Autonomous Prefecture,Liangshan,Sichuan,615000,China;不详)

机构地区：[1]凉山彝族自治州第一人民医院,四川凉山615000 [2]凉山彝族自治州布拖县人民医院

出　　处：《中国冶金工业医学杂志》2024年第5期497-498,共2页Chinese Medical Journal of Metallurgical industry

基　　金：凉山州科技计划资助(项目编号:22ZDYF0100)。

摘　　要：目的分析全麻复合超声引导下,右美托咪定联合罗哌卡因腹横肌平面阻滞(TAPB)麻醉对药物成瘾腹部手术患者苏醒的影响。方法选取2022年1月—2023年2月我院40例拟行腹部手术的药物成瘾患者,按单双号法随机将其分为对照组与观察组,每组各20例。两组分别采用不同麻醉方法并分析麻醉效果。结果观察组瑞芬太尼用量、舒芬太尼用量、苏醒期躁动评分、戒断症状评分均显著低于对照组(t=4.443、3.195、2.680、10.128,均P<0.05),戒断症状发生率低于对照组(χ^(2)=4.329,P<0.05);观察组术后6、12、24、48 h的VAS评分均显著低于对照组(F_(组间)=6.85、F_(时间)=17.25、F_(组间×时间)=8.14,均P<0.001),镇静评分显著高于对照组(t=3.850,P<0.05);两组不良反应发生率比较无显著差异(χ^(2)=000,P>0.05)。结论在超声引导下,对药物成瘾腹部手术患者采用右美托咪定联合罗哌卡因TAPB麻醉,能有效减少阿片类药物用量、预防苏醒期躁动、降低戒断症状的发生率。Objective To analyze the impact of general anesthesia combined with ultrasound-guided transversus abdominis plane block(TAPB)using dexmedetomidine and ropivacaine on patients with drug addiction undergoing abdominal surgery.Methods From January 2022 to February 2023,a total of 40 patients with drug addiction who planned to undergo abdominal surgery in our hospital were selected and randomly divided into control group and observation group according to odd and even numbers,with 20 cases in each group.Different anesthesia methods were used in the two groups,and the effects of anesthesia were analyzed.Results The observation group had significantly lower consumption of remifentanil,sufentanil,agitation scores during awakening,and withdrawal symptom scores compared to the control group(t=4.443,3.195,2.680,10.128,all P<0.05),and the incidence of withdrawal symptoms was lower in the observation group(χ^(2)=4.329,P<0.05).The Visual Analog Scale(VAS)scores at 6,12,24,and 48 hours postoperatively in the observation group were significantly lower than those in the control group(F_(bewen groups)=6.85,F_(time)=17.25,F_(beween groups×time)=8.14,all P<0.001),and the sedation scores were significantly higher in the observation group(t=3.850,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.000,P>0.05).Conclusion Under ultrasound guidance,using dexmedetomidine combined with ropivacaine TAPB anesthesia for drug-addicted patients undergoing abdominal surgery can effectively reduce the consumption of opioid drugs,prevent agitation during awakening,and decrease the incidence of withdrawal symptoms.

关 键 词：右美托咪定 罗哌卡因 药物成瘾者 苏醒质量 

分 类 号：R614[医药卫生—麻醉学]