右美托咪定复合罗哌卡因对乳腺手术患者行胸椎旁神经阻滞麻醉效果的影响

发布时间：2019-04-13 13:25

【摘要】：目的:观察右美托咪定复合罗哌卡因行胸椎旁神经阻滞麻醉对乳腺包块切除术的临床效果。方法:选择择期行乳腺包块手术患者60例,用随机双盲法分为对照组(C组,n=30)及实验组(D组,n=30),每组各30例,实验组给予(右美托咪定1μg·kg-1+0.375%罗哌卡因20 ml)行胸椎旁神经阻滞,对照组给予(0.375%罗哌卡因20 ml+同实验组右美托咪定容积0.9%氯化钠)行胸椎旁神经阻滞。分别记录患者入室时(T_0)、胸椎旁神经阻滞后15 min(T_1)、手术开始时(T_2)、肿块切除时(T_3)、手术结束时(T_4)的HR(心率)、MAP(平均动脉压)、SpPO2(血氧饱和度)和Ramsay镇静评分。观察2组感觉神经阻滞起效时间、感觉神经阻滞恢复时间以及术后不良反应发生情况。结果:实验组与对照组比较,在T_1~T_4时MAP降低、HR减慢,差异有统计学意义(P0.05)。实验组在T_1~T_4时的Ramsay评分高于对照组,差异有统计学意义(P0.05)。2组在T_0时MAP、HR及各时点SpO2比较,差异无统计学意义(P0.05)。实验组感觉神经阻滞恢复时间比对照组延长,差异有统计学意义(P0.01)。实验组术后不良反应发生率与对照组比较,差异无统计意义(P0.05)。结论:右美托咪定复合罗哌卡因用于乳腺乳腺包块切除术,可明显增强胸椎旁神经阻滞麻醉效果,保持血流动力学的稳定、缩短感觉神经阻滞起效时间、延长感觉神经阻滞恢复时间,利于术后镇痛。
[Abstract]:Objective: to observe the clinical effect of right metomidine combined with ropivacaine in thoracic paravertebral nerve block anesthesia for breast mass resection. Methods: 60 patients undergoing breast mass surgery were randomly divided into control group (group C, n = 30) and experimental group (group D, n = 30), 30 cases in each group, and 30 cases in group C (n = 30) and group D (n = 30) in random double blind method. In the experimental group (right metametrimidine 1 渭 g kg-1 0.375% ropivacaine 20 ml), the paravertebral nerve block was performed. Thoracic paravertebral nerve block was performed in the control group (0.375% ropivacaine 20 ml and right metametidine 0.9% NaCl). HR (heart rate) was recorded at the time of entry (T0), after thoracic paravertebral nerve block (min 1), at the beginning of surgery (T), at the time of mass resection (T), and at the end of the operation (T), respectively, at the time of entry (T), after thoracic paravertebral nerve block (T). MAP (mean arterial pressure), SpPO2 (saturation of blood oxygen) and Ramsay sedation score. The onset time of sensory nerve block, the recovery time of sensory nerve block and the occurrence of postoperative adverse reactions were observed. Results: compared with the control group, MAP and HR decreased significantly in the experimental group (P0.05). The Ramsay score of the experimental group at T0 was higher than that of the control group (P0.05). There was no significant difference between the two groups in MAP,HR at T0 and SpO2 at each time point (P0.05). The recovery time of sensory nerve block in the experimental group was longer than that in the control group, the difference was statistically significant (P0.01). There was no significant difference in the incidence of adverse reactions between the experimental group and the control group (P0.05). Conclusion: right metomidine combined with ropivacaine can significantly enhance the anesthetic effect of thoracic paravertebral nerve block, maintain the stability of hemodynamics and shorten the onset time of sensory nerve block. Prolonging the recovery time of sensory nerve block is beneficial to postoperative analgesia.
【作者单位】：武汉市汉口医院麻醉科;
【分类号】：R614

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