地佐辛不同给药方式在腰丛-坐骨神经联合阻滞中镇痛效果的比较

发布时间：2018-04-25 23:08

本文选题：地佐辛 + 不同给药方式　；参考：《广东医学》2017年18期

【摘要】：目的地佐辛局部与静脉两种给药方式在腰丛-坐骨神经联合阻滞镇痛效果的比较。方法选取行下肢手术的患者60例,ASA分级Ⅰ~Ⅲ级,根据地佐辛不同给药方式,随机分为两组[局部给药组(A组),静脉给药组(B组),n=30]。A组将5 mg地佐辛与2%利多卡因10 m L、1.192%罗哌卡因20 m L用生理盐水稀释至60m L,腰丛及坐骨神经阻滞点处各注射30 m L;B组将2%利多卡因10 m L、1.192%罗哌卡因20 m L用生理盐水稀释至60 m L,腰丛及坐骨神经阻滞点处各注射30 m L,成功后静脉给予5 mg地佐辛。观察比较两组患者麻醉阻滞前后血流动力学变化及腰丛-坐骨神经穿刺成功间隔时间、麻醉效果、阻滞效果,记录术中头晕、恶心、呼吸抑制等不良反应情况。结果两组患者麻醉前后血流动力学比较差异无统计学意义(P0.05),A组患者运动神经阻滞和感觉神经阻滞起效时间明显短于B组(P0.05);B组患者术中镇痛药用药次数多于A组,A组麻醉效果优于B组,差异有统计学意义(P0.05)。A组不良反应明显少于B组(P0.05)。结论地佐辛可以采用静脉和局部两种给药途径作为腰丛-坐骨神经阻滞的辅助用药,但局部给药增强腰丛-坐骨神经阻滞的镇痛效果,对呼吸影响小,有利于维持患者的生理状态,安全性好。
[Abstract]:Objective: to compare the analgesic effect of local and intravenous administration of Zoxin in lumbar plexus and sciatic nerve block. Methods A total of 60 patients undergoing lower extremity surgery were enrolled in this study. Two groups were randomly divided into two groups: group A (local administration), group B (intravenous injection), group B (n = 30). Group A diluted 5 mg of dizosin and 2% lidocaine (10 mL / L) with normal saline to 60 mL, lumbar plexus and sciatic nerve block points respectively by injection of 5 mg of dizosin and 2% lidocaine 10 mL / L of ropivacaine 20 mL with normal saline. In group B, 2% lidocaine (10 mL) 1.1922% ropivacaine (20 mL) was diluted with normal saline to 60 mL, and 30 mL was injected into lumbar plexus and sciatic nerve block point respectively. The hemodynamic changes before and after anesthesia and the time of successful lumbar plexus-sciatic nerve puncture were observed and compared between the two groups. The adverse reactions such as dizziness nausea and respiratory inhibition were recorded. Results there was no significant difference in hemodynamics between the two groups before and after anesthesia. The onset time of motor nerve block and sensory nerve block in group A was significantly shorter than that in group B and group B was significantly shorter than that in group A. The anesthetic effect of group B was better than that of group B. The adverse reactions in group A were significantly lower than those in group B (P 0.05). Conclusion Dizosin can be used as an adjuvant drug for lumbar plexus-sciatic nerve block by intravenous and local administration, but local administration can enhance the analgesic effect of lumbar plexus-sciatic nerve block and have little effect on respiration. It is beneficial to maintain the physiological state of the patient, and the safety is good.
【作者单位】：哈励逊国际和平医院麻醉科;
【分类号】：R614

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