不同剂量右美托咪定混合罗哌卡因椎旁阻滞在开胸术后的镇痛效果

发布时间：2018-04-28 01:46

  本文选题：右美托咪定 + 罗哌卡因　； 参考：《中国新药与临床杂志》2017年02期

【摘要】：目的探讨不同剂量右美托咪定混合罗哌卡因椎旁阻滞在开胸手术后的镇痛效果。方法择期全麻下行开胸肺癌根治术患者60例,随机分为四组,每组15例。对照组诱导前椎旁给药及术后镇痛仅用罗哌卡因。右美托咪定剂量1组(Dex1组)、右美托咪定剂量2组(Dex2组)、右美托咪定剂量3组(Dex3组)诱导前椎旁给予0.35%罗哌卡因0.3 mL·kg~(-1)和右美托咪定1μg·kg~(-1),术后椎旁患者自控镇痛(PCA)使用0.2%罗哌卡因和右美托咪定1、2、4μg·kg~(-1)。必要时静脉给予地佐辛,维持术后48 h内疼痛视觉模拟量表(VAS)评分≤3分。记录各组阻滞后30 min,术后24 h,PCA结束后12、24 h的感觉阻滞节段数;术后48 h内PCA按压次数及地佐辛用量。比较各组围术期不良反应发生情况。结果阻滞后30 min及术后24 h Dex1组、Dex2组、Dex3组感觉阻滞节段数多于对照组(P0.05);PCA结束后12、24 h,Dex2组与Dex3组感觉阻滞节段数多于Dex1组及对照组(P0.05)。Dex2组与Dex3组术后PCA按压次数及地佐辛用量少于Dex1组及对照组(P0.05)。Dex2组与Dex3组各时点感觉阻滞节段数、术后PCA按压次数及地佐辛用量无显著差异(P0.05)。Dex3组心动过缓、嗜睡发生率高于其他三组(P0.05)。结论右美托咪定混合罗哌卡因椎旁阻滞用于开胸术后镇痛可增加阻滞范围,增强镇痛效果,其中右美托咪定2μg·kg~(-1)混合罗哌卡因术后持续镇痛,效果良好,不良反应较少。
[Abstract]:Objective to investigate the analgesic effect of dexmetomidine combined with ropivacaine in paravertebral block after thoracotomy. Methods 60 patients with open chest lung cancer were randomly divided into four groups, 15 cases in each group. The patients in the control group were treated with ropivacaine only before paravertebral administration and postoperative analgesia. Dex1, Dex1, Dex2, Dex3, Dex2 and Dex3) were given paravertebral administration of 0.35% ropivacaine 0.3 mL kg-1) and dexmetomidine 1 渭 g kg-1 before induction. Ropivacaine 0.2% and dexmetomidine 4 渭 g 路kg ~ (-1) 路kg ~ (-1). When necessary, dizosin was given intravenously and the visual analogue pain scale (VAS) score was 鈮，

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