右美托咪定混合罗哌卡因腹横肌平面阻滞在子宫切除术的应用

发布时间：2018-04-02 07:07

本文选题：右美托咪定　切入点：罗哌卡因　出处：《江苏医药》2016年22期

【摘要】：目的观察右美托咪定混合罗哌卡因腹横肌平面阻滞(TAPB)在全麻下行子宫切除术患者中的应用。方法择期全麻下行子宫切除术患者60例随机均分为罗哌卡因组(R组)和右美托咪定混合罗哌卡因组(DR组)。两组均于诱导结束后超声引导下行双侧TAPB,DR组予右美托咪定1μg/kg混合0.25%罗哌卡因共40ml,R组给予0.25%罗哌卡因40ml,每侧各20ml。患者术后均使用舒芬太尼静脉自控镇痛。记录麻醉药物用量、患者苏醒时间和拔出喉罩时间。比较两组患者术后2(T1)、4(T2)、8(T3)、12(T4)和24h(T5)的Ramsay镇静评分、静息和活动时VAS疼痛评分。记录术后24h阿片类药物的用量及不良反应发生情况。结果与R组相比,DR组丙泊酚和雷米芬太尼用量减少,患者苏醒时间和拔除喉罩时间缩短,T1、T2、T3时静息和活动VAS疼痛评分降低,24h阿片类用药量和恶心、呕吐发生率降低(P0.05)。两组Ramsay镇静评分差异无统计学意义(P0.05)。结论全麻下子宫切除术患者采用右美托咪定混合罗哌卡因TAPB麻醉恢复快,术后镇痛作用强,阿片类药物用量和不良反应少。
[Abstract]:Objective to investigate the effect of dexmedetomidine combined with ropivacaine transversus abdominis plane block (TAPB) resection in patients under general anesthesia. Methods of uterine hysterectomy under general anesthesia for 60 cases of patients were randomly divided into ropivacaine group (group R) and dexmedetomidine mixed ropivacaine group (DR group). Two groups were induced in the end after ultrasound-guided bilateral TAPB, DR group was treated with dexmedetomidine 1 g/kg 0.25% ropivacaine mixed 40ml, R group was given 0.25% ropivacaine 40ml, intravenous patient-controlled analgesia with sufentanil were used in each side of the 20ml. patients after operation. Anesthesia medication dosage, recovery time of patients and LMA extubation time of patients compared with two. After the group 2 (T1), 4 (T2), 8 (T3), 12 (T4) and 24h (T5) Ramsay sedation score, VAS pain score and resting activities. Records of the occurrence of postoperative 24h opioid dosage and adverse reactions. Results compared with R group, DR group of propofol Reduce and remifentanil dosage, recovery time and shorten the time of pulling out the laryngeal mask in patients, T1, T2, and VAS activity decreased resting pain score T3, 24h opioid dosage and reduce the incidence of nausea and vomiting (P0.05). The two groups had no statistically significant Ramsay sedation score (P0.05). Conclusion the uterus under general anesthesia excision of patients using dexmedetomidine mixed TAPB ropivacaine anesthesia recovery, postoperative analgesia, opioid consumption and less adverse reactions.

【作者单位】：南京医科大学附属南京医院(南京市第一医院)麻醉科;
【分类号】：R614

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