右美托咪定对左布比卡因腹横肌平面阻滞的影响

发布时间：2018-07-16 16:36

【摘要】：目的探讨混合右美托咪定(Dex)对左布比卡因腹横肌平面阻滞(TAPB)镇痛效果的影响。方法选择60例择期行经腹子宫全切患者,随机分为对照组和试验组,每组30例。全麻诱导后行TAPB,对照组采用0.25%左布比卡因40 m L,试验组在对照组用药基础上合用Dex 0.5μg·kg-1。记录两组镇痛时间(实施TAPB至术后第一次使用患者静脉自控镇痛泵的时间)、术后24 h镇痛泵舒芬太尼用量,采用疼痛VAS评分评估术后1、4、8、12、24 h的疼痛程度,观察记录两组不良反应发生情况。结果试验组镇痛时间(905.0±114.2)min,较对照组明显延长[(741.4±105.3)min,P0.05]。术后24 h内,舒芬太尼用量试验组为(29.4±1.2)μg,少于对照组[(47.4±2.0)μg,P0.05],术后8、12 h静息状态下疼痛VAS评分试验组低于对照组(P0.05),且试验组患者满意度高于对照组(P0.05)。两组呼吸抑制、低血压、心动过缓等发生率无显著差异(P0.05)。结论 Dex可延长左布比卡因TAPB镇痛时间,减少术后镇痛药用量,并且未增加不良反应的发生。
[Abstract]:Objective to investigate the analgesic effect of mixed dexmetomidine (Dex) on left bupivacaine abdominal transverse muscle block (TAPB). Methods 60 patients with total hysterectomy were randomly divided into control group and experimental group with 30 cases in each group. After induction of general anesthesia, TAPBand was used in the control group. The control group was treated with 0.25% levobupivacaine 40 mL, and the experimental group was treated with Dex 0.5 渭 g kg-1 on the basis of the medication in the control group. The time of analgesia (from the time of TAPB to the first time after operation) and the dosage of sufentanil at 24 hours after operation were recorded. The pain degree was evaluated by pain VAS score. Adverse reactions were observed and recorded in both groups. Results the analgesic time in the experimental group was (905.0 卤114.2) min, which was significantly longer than that in the control group [(741.4 卤105.3) min (P0.05)]. Within 24 hours after operation, the dosage of sufentanil was (29.4 卤1.2) 渭 g in the experimental group, less than that in the control group [(47.4 卤2.0) 渭 g (P0.05)]. The VAS score of pain in the experimental group was lower than that in the control group at 8 h after operation (P0.05), and the patient satisfaction in the experimental group was higher than that in the control group (P0.05). There was no significant difference in respiratory depression, hypotension and bradycardia between the two groups (P0.05). Conclusion Dex can prolong the analgesic time of TAPB with levobupivacaine, reduce the dosage of analgesic after operation, and do not increase the occurrence of adverse reactions.
【作者单位】：嘉兴学院附属妇儿医院/嘉兴市妇幼保健院麻醉科;
【分类号】：R614

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