本文關(guān)鍵詞：不同濃度右美托咪定對(duì)羅哌卡因行連續(xù)股神經(jīng)阻滯鎮(zhèn)痛效果及安全性的動(dòng)物研究　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 右美托咪定 連續(xù)股神經(jīng)阻滯 脫髓鞘 圖像分析

【摘要】：目的:采用動(dòng)物行為學(xué)和細(xì)胞病理學(xué)評(píng)估右美托咪定聯(lián)合羅哌因在兔連續(xù)股神經(jīng)阻滯應(yīng)用中的有效性及安全性。方法:健康新西蘭兔30只,體重2~3kg,雌雄不分,采用隨機(jī)數(shù)字表法,將其分為5組(n=6),空白對(duì)照組(A組)、羅哌卡因組(B組)、右美托咪定1μg/ml組(C組)右美托咪定2μg/ml組(D組)、右美托咪定3ug/ml組(E組)。A組為生理鹽水組,B組為0.25%羅哌卡因組,C、D、E組為0.25%羅哌卡因聯(lián)合不同濃度的右美托咪定,分別為1μg/ml、2μg/ml、3μg/ml。在兔左下肢股神經(jīng)旁放置硬膜外導(dǎo)管,固定完善。完成置管后在膝關(guān)節(jié)髕骨上皮下注射5%福爾馬林0.5ml,連續(xù)股神經(jīng)阻滯動(dòng)物模型制作完成后,經(jīng)留置導(dǎo)管注入1ml鹽酸利多卡因,針刺法及手指觸摸法確定導(dǎo)管固定在位,6h后連接電子微量泵開(kāi)始泵注藥物。參數(shù)設(shè)置:背景劑量1ml,持續(xù)劑量0.5ml/h,每6小時(shí)單次追加注射1ml。實(shí)驗(yàn)兔連續(xù)股神經(jīng)阻滯48小時(shí)后將其處死,分離出股神經(jīng),進(jìn)行標(biāo)本制作。利用光學(xué)顯微鏡圖像分析儀軟件進(jìn)行股神經(jīng)髓鞘面積定量分析,利用透射電鏡對(duì)股神經(jīng)髓鞘,細(xì)胞器等細(xì)胞超微結(jié)構(gòu)進(jìn)行觀察。觀察指標(biāo):1.動(dòng)物行為學(xué)評(píng)分(0分—被注射腿明顯能承重,在驅(qū)趕或或蹲臥期間前后足及左右足無(wú)明顯差異;1分—被注射腿幾乎不能承重,在運(yùn)動(dòng)中有明顯跛行;2分—被注射腿抬高,不能承重;3分—搔抓,舔咬或搖被注射腿。觀察時(shí)間點(diǎn):T0:髕骨上皮下注射10%福爾馬林0.5ml即刻評(píng)估兔行為學(xué)評(píng)分;T1:注射背景劑量2h;T2:給藥6h,即第一次單次追加1ml藥物后;T3:給藥后24h,即第四次單次追加1ml藥物后。評(píng)估前用福爾馬林致痛,觀察兔膝關(guān)節(jié)致痛后行為學(xué)表現(xiàn)并記分)2.鎮(zhèn)痛起效時(shí)間:致痛后即刻到兔子恢復(fù)正常行走的時(shí)間。3.股神經(jīng)髓鞘面積定量分析。4.透射電鏡股神經(jīng)細(xì)胞結(jié)構(gòu)觀察。結(jié)果:與A組相比,B、C、D、E組在T1、T2及T3時(shí)刻行為學(xué)評(píng)分相比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。在T1、T2及T3時(shí)刻,B組與C組相比較差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05),B組與D、E組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),C組與D、E組比較差異有統(tǒng)計(jì)學(xué)(P0.05)。T1、T2及T3時(shí)刻D組與E組相比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。與A組相比較,B、C、D、E組開(kāi)始恢復(fù)行走時(shí)間較短,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),B組和C組相比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。C組與D組,E組相比較,恢復(fù)時(shí)間較長(zhǎng),差異具有統(tǒng)計(jì)學(xué)意義(P0.05),而D組和E組相比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)�？瞻讓�(duì)照組、羅哌卡因組、右美托咪定組,光鏡下髓鞘面積定量分析差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。A、B、C、D組電鏡結(jié)果顯示沒(méi)有出現(xiàn)脫髓鞘等神經(jīng)纖維變性的現(xiàn)象,E組電鏡結(jié)果顯示神經(jīng)纖維髓鞘板層疏松,呈空泡狀。結(jié)論:右美托咪定聯(lián)合羅哌卡因行股神經(jīng)阻滯可縮短起效時(shí)間,增強(qiáng)鎮(zhèn)痛效果,但高濃度右美托咪定(3μg/ml)聯(lián)合羅哌卡因行連續(xù)股神經(jīng)阻滯對(duì)兔股神經(jīng)可能存在潛在神經(jīng)損傷作用。
[Abstract]:Objective: to evaluate the efficacy and safety of dexmetomidine combined with ropipine in the treatment of continuous femoral nerve block in rabbits by animal behavior and cytopathology. Male and female were randomly divided into five groups: group A (control group) and group B (ropivacaine group). Right metoimidine 1 渭 g / ml group (group C) dexmetomidine 2 渭 g / ml group (group D), dexmetomidine group (group 3ug.ml) and group E (group A) were normal saline group. Group B was treated with 0.25% ropivacaine. Group E was treated with 0.25% ropivacaine combined with dexmetomidine at different concentrations (1 渭 g / ml / ml, 2 渭 g / ml, respectively). 3 渭 g / ml. The epidural catheter was placed next to the femoral nerve of the left lower extremity of the rabbit, and the fixation was perfect. 5% formalin 0.5ml was injected subcutaneously into the knee joint after the catheterization. After the establishment of the animal model of continuous femoral nerve block, 1 ml lidocaine hydrochloride was injected through the indwelling catheter, and the catheter was fixed in the position by acupuncture and finger touch. After 6 hours, the drug was pumped by the electronic micropump. The parameters were as follows: the background dose was 1 ml, the continuous dose was 0.5 ml / h. The rabbits were killed after 48 hours of continuous femoral nerve block and the femoral nerves were separated. The area of femoral nerve myelin sheath was quantitatively analyzed by using optical microscope image analyzer software, and the femoral nerve myelin sheath was obtained by transmission electron microscope (TEM). The ultrastructure of cell such as organelle was observed. The observation index was: 1. Animal behavior score (0 score-the injected leg could bear the weight obviously. There was no significant difference between the left and the right feet before and after driving or squatting; 1-the injected leg can hardly bear weight and has obvious limp during exercise; 2 points-raised by injection leg, can not bear weight; 3 points-scratch, lick, bite or shake injected leg. Observe time point: 0: 0: 10% formalin 0.5ml subcutaneously; assess immediately the behavior score of rabbits; T1: background dose 2 h; T2: after 6 hours of administration, 1ml was added for the first time. T3: 24 hours after administration, that is, 4th times a single dose of 1 ml of drugs. Before evaluation with formalin to cause pain. Observation of behavior and score after pain induced by knee joint in rabbits. 2. Analgesic effect time: the time from the immediate after pain to the rabbit to return to normal walk. Quantitative analysis of the area of femoral nerve myelin sheath. 4. Observation of the structure of femoral nerve cells under transmission electron microscope. Results: compared with group A. There were significant differences in behavioral scores at T _ 1 T _ 2 and T _ 3 in group E (P 0.05), and at T _ 2 and T _ 3 in T _ 1T _ 2 and T _ 3. There was no significant difference between group B and group C (P 0.05) and between group B (P 0.05) and group D (D). There was significant difference between group B and group C (P 0.05) and group D (P < 0.05). There was no significant difference between group D and group E at T _ 2 and T _ 3, and there was no significant difference between group E and group E, but there was no significant difference between group D and group A. The time to start walking was shorter in group E, and the difference was statistically significant. There was no significant difference between group B and group C. there was no significant difference between group C and group D. The recovery time was longer and the difference was statistically significant (P 0.05), but there was no significant difference between group D and group E. the blank control group, ropivacaine group and dexmetomidine group had no statistical significance. There was no significant difference in the quantitative analysis of myelin sheath area under light microscope. The electron microscopic results of group A (P0.05) showed no degeneration of nerve fibers such as demyelination. The electron microscopic results of group E showed that the myelin lamina of nerve fibers was loose and vacuolar. Conclusion: dexmetomidine combined with ropivacaine can shorten the onset time and enhance the analgesic effect. However, high concentration of dexmetomidine 3 渭 g / ml combined with ropivacaine for continuous femoral nerve block may have potential nerve injury effect on rabbit femoral nerve.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R614

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張春燕;張春玲;劉迎春;;股神經(jīng)阻滯自控鎮(zhèn)痛用于下肢遠(yuǎn)端骨折32例的護(hù)理[J];中國(guó)誤診學(xué)雜志;2011年11期

2 肖莉;吳緒才;董補(bǔ)懷;;股神經(jīng)阻滯用于股骨骨折患者麻醉前鎮(zhèn)痛的臨床研究[J];吉林醫(yī)學(xué);2011年17期

3 劉研;陳秀云;許瑩瑩;;護(hù)理干預(yù)對(duì)應(yīng)用股神經(jīng)阻滯止痛技術(shù)病人意外歪倒的影響[J];護(hù)理研究;2012年05期

4 祁雄峰;吳錦波;陳家泉;孫耿生;;股神經(jīng)阻滯在股骨骨折患者中的臨床應(yīng)用分析[J];亞太傳統(tǒng)醫(yī)藥;2013年03期

5 任玉香;李九群;張洪雷;胡會(huì)英;;連續(xù)股神經(jīng)阻滯鎮(zhèn)痛的護(hù)理方法與效果觀察[J];齊齊哈爾醫(yī)學(xué)院學(xué)報(bào);2013年13期

6 倪建農(nóng);劉向東;;不同置管方式在股神經(jīng)阻滯術(shù)后鎮(zhèn)痛中應(yīng)用的效果分析[J];當(dāng)代醫(yī)學(xué);2014年08期

7 陳亮,秦成偉,劉金昧;股神經(jīng)阻滯在膝部手術(shù)中的應(yīng)用[J];山東醫(yī)藥;2002年09期

8 南興東;賈東林;李水清;張利萍;余家闊;李民;;連續(xù)股神經(jīng)阻滯用于全膝關(guān)節(jié)置換術(shù)后康復(fù)鎮(zhèn)痛的臨床觀察[J];中國(guó)疼痛醫(yī)學(xué)雜志;2007年06期

9 蔡萍;崔燕;楊潔;;持續(xù)股神經(jīng)阻滯用于全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛[J];中國(guó)煤炭工業(yè)醫(yī)學(xué)雜志;2009年04期

10 嚴(yán)婭嵐;楊光;吳文知;張?zhí)m;;連續(xù)股神經(jīng)阻滯在膝關(guān)節(jié)鏡術(shù)后鎮(zhèn)痛及早期康復(fù)中的應(yīng)用[J];四川醫(yī)學(xué);2012年02期

相關(guān)會(huì)議論文 前9條

1 石英;魯開(kāi)智;;股神經(jīng)阻滯在全膝關(guān)節(jié)置換術(shù)康復(fù)鎮(zhèn)痛中的應(yīng)用[A];2009年西部麻醉學(xué)術(shù)論壇論文匯編[C];2009年

2 石英;魯開(kāi)智;;股神經(jīng)阻滯在全膝關(guān)節(jié)置換術(shù)康復(fù)鎮(zhèn)痛中的應(yīng)用[A];第十五次長(zhǎng)江流域麻醉學(xué)學(xué)術(shù)年會(huì)暨2010年中南六省麻醉學(xué)學(xué)術(shù)年會(huì)暨2010年湖北省麻醉學(xué)學(xué)術(shù)年會(huì)論文集[C];2010年

3 李國(guó)輝;;連續(xù)股神經(jīng)阻滯鎮(zhèn)痛的護(hù)理體會(huì)[A];中華護(hù)理學(xué)會(huì)第14屆全國(guó)手術(shù)室護(hù)理學(xué)術(shù)交流會(huì)議論文匯編（中冊(cè)）[C];2010年

4 孫靖;;人工全膝關(guān)節(jié)置換術(shù)后行連續(xù)股神經(jīng)阻滯鎮(zhèn)痛的護(hù)理[A];全國(guó)第九屆骨科護(hù)理學(xué)術(shù)交流暨專(zhuān)題講座會(huì)議論文匯編[C];2007年

5 范國(guó)明;龔遂良;戴加平;陳剛;;股神經(jīng)阻滯對(duì)兔血清、脊髓、滑膜P物質(zhì)的影響[A];2012年浙江省骨科學(xué)術(shù)年會(huì)論文集[C];2012年

6 范國(guó)明;陳其昕;龔遂良;戴加平;陳剛;;股神經(jīng)阻滯對(duì)兔血清、脊髓、滑膜P物質(zhì)的影響[A];2013中國(guó)工程院科技論壇暨浙江省骨科學(xué)學(xué)術(shù)年會(huì)論文摘要集[C];2013年

7 �？巳�;馬金孝;胡紅玲;郭志芳;馮桂存;;股神經(jīng)阻滯自控鎮(zhèn)痛用于老年全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛臨床觀察[A];2009年西部麻醉學(xué)術(shù)論壇論文匯編[C];2009年

8 汪玉林;魯開(kāi)智;;七氟醚聯(lián)合股神經(jīng)阻滯在70歲以上老年患者股骨內(nèi)固定手術(shù)中應(yīng)用體會(huì)[A];第十五次長(zhǎng)江流域麻醉學(xué)學(xué)術(shù)年會(huì)暨2010年中南六省麻醉學(xué)學(xué)術(shù)年會(huì)暨2010年湖北省麻醉學(xué)學(xué)術(shù)年會(huì)論文集[C];2010年

9 汪玉林;魯開(kāi)智;;七氟醚聯(lián)合股神經(jīng)阻滯在70歲以上老年患者股骨內(nèi)固定手術(shù)中應(yīng)用體會(huì)[A];2009年西部麻醉學(xué)術(shù)論壇論文匯編[C];2009年

相關(guān)博士學(xué)位論文 前1條

1 彭周全;股神經(jīng)阻滯對(duì)全麻下膝關(guān)節(jié)置換術(shù)老年患者術(shù)后鎮(zhèn)痛和早期認(rèn)知功能的影響[D];鄭州大學(xué);2014年

相關(guān)碩士學(xué)位論文 前10條

1 龐佳寧;TKA術(shù)后連續(xù)股神經(jīng)阻滯早期鎮(zhèn)痛療效研究[D];昆明醫(yī)科大學(xué);2015年

2 景顏;股神經(jīng)阻滯和舒芬太尼用于髖部骨折麻醉前鎮(zhèn)痛效果的比較[D];山西醫(yī)科大學(xué);2016年

3 林榮坤;連續(xù)股神經(jīng)阻滯對(duì)全膝置換術(shù)（TKA）后鎮(zhèn)痛及早期功能康復(fù)的研究[D];廣州中醫(yī)藥大學(xué);2016年

4 韋秋鳳;不同濃度右美托咪定對(duì)羅哌卡因行連續(xù)股神經(jīng)阻滯鎮(zhèn)痛效果及安全性的動(dòng)物研究[D];廣西醫(yī)科大學(xué);2017年

5 秦國(guó)慶;持續(xù)股神經(jīng)阻滯對(duì)全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛及早期康復(fù)臨床研究[D];吉林大學(xué);2013年

6 劉艷艷;連續(xù)股神經(jīng)阻滯用于全膝關(guān)節(jié)置換患者術(shù)后鎮(zhèn)痛的臨床研究[D];重慶醫(yī)科大學(xué);2012年

7 陸國(guó)海;不同股神經(jīng)阻滯配方對(duì)全膝關(guān)節(jié)置換術(shù)后疼痛及應(yīng)激反應(yīng)的影響[D];蘇州大學(xué);2013年

8 唐帥;連續(xù)股神經(jīng)阻滯對(duì)全膝關(guān)節(jié)置換術(shù)后疼痛、康復(fù)和應(yīng)激反應(yīng)的影響[D];中國(guó)協(xié)和醫(yī)科大學(xué);2009年

9 單海華;超聲引導(dǎo)連續(xù)股神經(jīng)阻滯用于全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛的臨床研究[D];蘇州大學(xué);2012年

10 梁大寶;膝關(guān)節(jié)置換術(shù)中單次股神經(jīng)阻滯與局部浸潤(rùn)鎮(zhèn)痛的效果對(duì)比研究[D];安徽醫(yī)科大學(xué);2014年

，

本文編號(hào)：1410022