右美托咪定混合低浓度的罗哌卡因在老年患者腰丛阻滞中的应用

发布时间：2019-05-29 05:16

【摘要】：目的观察两种剂量的右美托咪定混合低浓度的罗哌卡因用于老年患者腰丛阻滞的效果和安全性。方法选择行单侧下肢手术的老年患者90例,随机分为三组:腰丛阻滞定位成功后,A组注入0.25%罗哌卡因35 mL,B组注入等量的罗哌卡因和右美托咪定0.5μg/kg,C组注入等量的罗哌卡因和右美托咪定1μg/kg。观察腰丛阻滞的起效时间、持续时间、阻滞范围和不良反应,比较术中镇静评分、血压、心率、呼吸和术后镇痛药用量。结果 (1)感觉和运动阻滞的起效时间:C组B组A组(P0.01),持续时间:C组B组A组(P0.01);(2)血压和心率:C组B组A组(P0.05),镇静评分:C组大于A和B组(P0.05),术后镇痛药用量:C组B组A组(P0.05);(3)B、C组麻醉效果满意,A组有6例(20%)患者因镇痛不全需辅助静脉麻醉。结论 0.5~1μg/kg的右美托咪定混合低浓度(0.25%)的罗哌卡因用于老年患者腰丛阻滞可获得良好的阻滞效果,同时镇静适度,呼吸、循环稳定,不良反应少。
[Abstract]:Objective to observe the efficacy and safety of two doses of dexmetomide mixed with low concentration ropivacaine in elderly patients with lumbar block. Methods 90 elderly patients undergoing unilateral lower extremity surgery were randomly divided into three groups: group A (0.25% ropivacaine 35 mL,B) was injected with 0.5 渭 g / kg, of ropivacaine and dexmetiomide 0.5 渭 g / min after successful localization of lumbar block. Group C was injected with the same amount of ropivacaine and dexmetiomide 1 渭 g / kg. The onset time, duration, range and side effects of lumbar block were observed. Intraoperative sedation score, blood pressure, heart rate, respiratory and postoperative analgesic dosage were compared. Results (1) the onset time of sensory and motor block: group C, group B, group A (P 0.01), group C, group B, group A (P 0.01); (2) Blood pressure and heart rate: group C, group B, group A (P 0.05), sedation score: group C was larger than group A and group B (P 0.05), postoperative analgesic dosage: group C, group B, group A (P 0.05); (3) B, the anesthetic effect of group C was satisfactory. 6 patients (20%) in group A needed auxiliary intravenous anesthesia because of incomplete analgesia. Conclusion 0.5 ~ 1 渭 g / kg dexmetomide mixed with low concentration (0.25%) ropivacaine can achieve good blocking effect in elderly patients with lumbar block. At the same time, moderate sedation, stable respiration, stable circulation and less adverse reactions can be obtained.
【作者单位】：中山大学孙逸仙纪念医院麻醉科;中山大学孙逸仙纪念医院增城院区麻醉科;
【基金】：广东省科技计划项目(编号:2017A020215161) 广东省医院药学研究基金(编号:2016MZ13)
【分类号】：R614

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