右美托咪定复合罗哌卡因收肌管阻滞在胫骨折患者术前超前镇痛中的应用  

Application of Dexmedetomidine Combined with Ropivacaine Adductor Canal Block in Pre-operative Preemptive Analgesia in Patients with Tibial Fractures

作　　者：祁恩耀 许娟 龚睿 张云辉 王鹏 QI Enyao;XU Juan;GONG Rui;ZHANG Yunhui;WANG Peng(Department of Anesthesiology,Liuhe District People's Hospital,Nanjing 211500,Jiangsu,China)

机构地区：[1]南京市六合区人民医院麻醉科,江苏南京211500

出　　处：《系统医学》2024年第19期64-67,共4页Systems Medicine

基　　金：2020年南京市医学科技项目(YKK20205)。

摘　　要：目的 探讨在胫骨骨折患者收肌管阻滞超前镇痛中联用右美托咪定与罗哌卡因的价值。方法 非随机选取南京市六合区人民医院于2021年6月—2023年9月收治的60例下肢骨折患者为研究对象,均予收肌管阻滞,按麻醉方式不同分为两组,每组30例,对照组使用单纯罗哌卡因,观察组使用罗哌卡因联用右美托咪定。比较两组静息及活动时疼痛评分、血流动力学指标及不良反应发生率。结果 阻滞后2、6、12 h,观察组静息疼痛(1.74±0.30)分、(2.08±0.35)分、(2.25±0.38)分,活动疼痛(3.24±0.70)分、(3.41±0.72)分、(3.75±0.77)分,高于对照组,差异有统计学意义(t=3.327、3.963、6.162、4.808、5.913、5.267,P<0.05)。阻滞后,观察组心率(72.05±4.39)次/min、平均动脉压(84.24±5.10)mmHg,均低于对照组,差异有统计学意义(t=4.629、3.390,P<0.05).两组不良反应发生率差异无统计学意义(P>0.05)。结论 对胫骨骨折患者在收肌管阻滞超前镇痛中使用右美托咪定复合罗哌卡因能减轻术后疼痛,可稳定血流动力学指标,安全性高。Objective To investigate the value of dexmedetomidine and ropivacaine in adductor Cancl block and ad-vance analgesia in patients with tibial fracture.Methods A total of sixty patients with lower extremity fracture treated in Nanjing Liuhe District People's Hospital from June 2021 to September 2023 were non-randomly selected as the study subjects,all of whom were given adductor block.They were divided into two groups according to different anes-thesia methods,with thirty cases in each group.The control group received ropivacaine alone,and the observation group received Ropivacaine combined with dexmedetomidine.The resting and cative periods pain score,hemodynamic indexes and the incidence of adverse reactions were compared between the two groups.Results At 2,6,and 12 h after block,the resting pain(1.74±0.30)points,(2.08±0.35)points,(2.25±0.38)points,and activity pain(3.24±0.70)points,(3.41±0.72)points,(3.75±0.77)points in the observation group were higher than those in the control group,and the differences were statistically significant(t=3.327,3.963,6.162,4.808,5.913,5.267,P<0.05).After block,the heart rate(72.05±4.39)times/min and mean arterial pressure(84.24±5.10)mmHg in the observation group were lower than those in the control group,and the differences were statistically significant(t=4.629,3.390,P<0.05).Conclusion Dex-medetomidine combined with ropivacaine can reduce postoperative pain,stabilize hemodynamic parameters and have high safety in the adductor canal block preemptive analgesia for patients with tibial fracture.

关 键 词：右美托咪定 罗哌卡因 胫骨骨折 超前镇痛 疼痛 不良反应 

分 类 号：R4[医药卫生—临床医学]