不同剂量右美托咪定复合罗哌卡因腰硬联合麻醉对腹腔镜子宫切除术患者术后恢复的影响  

Effect of Different Doses of Dexmedetomidine Combined with Ropivacaine Combined Spinal-eqidural Anesthesia on Postoperative Recovery of Patients Undergoing Laparoscopic Hysterectomy

作　　者：唐兢 李荣林 袁峰 TANG Jing;LI Ronglin;YUAN Feng(Department of Anesthesiology,the 924th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Guilin 541002,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第九二四医院麻醉科,广西桂林541002

出　　处：《中国医学创新》2025年第1期121-125,共5页Medical Innovation of China

摘　　要：目的:探究不同剂量右美托咪定复合罗哌卡因腰硬联合麻醉对腹腔镜子宫切除术患者术后恢复的影响。方法:回顾性选取2022年1月—2023年12月在中国人民解放军联勤保障部队第九二四医院进行腰硬联合麻醉腹腔镜子宫切除术的100例患者的临床资料,根据右美托咪定用量不同分为三组,A组35例患者采用0.75%罗哌卡因复合0.5μg/kg右美托咪定进行麻醉,B组32例患者采用0.75%罗哌卡因复合1.0μg/kg右美托咪定,C组33例患者采用0.75%罗哌卡因复合1.5μg/kg右美托咪定。比较三组麻醉苏醒时间、首次肛门排气时间、下床活动时间与术后24 h舒芬太尼使用量,术后6、12、24 h疼痛视觉模拟评分法(visual analogue scale,VAS)评分,麻醉前(T0)、术后2 h(T_(1))、术后24 h(T_(2))时血流动力学指标,术后不良反应发生情况。结果:与A组比较,B组和C组麻醉苏醒时间、首次肛门排气时间及下床活动时间均较早(P<0.05),术后24 h舒芬太尼使用量较少(P<0.05),术后6、12、24 h的VAS评分均更低(P<0.05)。三组T_(1)、T_(2)时心率(HR)、平均动脉压(mean arterial pressure,MAP)较T0时均更低,T_(2)时均较T_(1)升高(P<0.05),与A组比较,B组和C组HR、MAP均低(P<0.05)。A组与B组术后口干发生率为2.86%、6.25%,均低于C组的21.21%(P<0.05)。结论:采用剂量为1.0μg/kg右美托咪定复合罗哌卡因对腰硬联合麻醉对腹腔镜子宫切除术患者镇痛效果更好,术后恢复更快,术后血流动力学指标与不良反应发生率更低,更具有安全性。Objective:To explore the effect of different doses of Dexmedetomidine combined with Ropivacaine combined spinal-eqidural anesthesia on postoperative recovery of patients undergoing laparoscopic hysterectomy.Method:The clinical data of 100 patients undergoing laparoscopic hysterectomy under combined spinal-epidural anesthesia in the 924 Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from January 2022 to December 2023 were retrospectively selected and divided into three groups according to the different dosage of Dexmedetomidine.35 patients in group A were anesthetised with 0.75%Ropivacaine combined with 0.5µg/kg Dexmedetomidine.Thirty-two patients in group B were treated with 0.75%Ropivacaine combined with 1.0µg/kg Dexmedetomidine,and 33 patients in group C were treated with 0.75%Ropivacaine combined with 1.5µg/kg Dexmedetomidine.The anesthesia recovery time,first anal exhaust time,getting out of bed time and the amount of Sufentanil used within 24 h after surgery,visual analogue scale(VAS)scores at 6,12 and 24 h after surgery,hemodynamic indexes before anesthesia(T0),2 h after surgery(T_(1))and 24 h after surgery(T_(2)),and the incidence of postoperative adverse reactions of the three groups were compared.Result:Compared with group A,the anesthesia recovery time,first anal exhaust time and getting out of bed time in group B and group C were earlier(P<0.05),the amount of Sufentanil used within 24 h after surgery was less(P<0.05),and the VAS scores at 6,12 and 24 h after surgery were lower(P<0.05).Heart rate(HR)and mean arterial pressure(MAP)of three group at T_(1) and T_(2) were lower at than those at T0,those at T_(2) were higher than those at T_(1)(P<0.05).Compared with group A,HR,MAP of group B and group C were lower(P<0.05).The incidence of postoperative dry mouth in group A and group B was 2.86%and 6.25%,both lower than 21.21%in group C(P<0.05).Conclusion:Using a dose of 1.0µg/kg Dexmedetomidine combined with Ropivacaine for combined spinal-epidural anesthesia in pa

关 键 词：右美托咪定 罗哌卡因 腰硬联合麻醉 腹腔镜子宫切除术 术后恢复 

分 类 号：R614[医药卫生—麻醉学]