本文選題：右美托咪定　切入點：羅哌卡因　出處：《江蘇醫(yī)藥》2016年22期

【摘要】：目的觀察右美托咪定混合羅哌卡因腹橫肌平面阻滯(TAPB)在全麻下行子宮切除術(shù)患者中的應(yīng)用。方法擇期全麻下行子宮切除術(shù)患者60例隨機均分為羅哌卡因組(R組)和右美托咪定混合羅哌卡因組(DR組)。兩組均于誘導(dǎo)結(jié)束后超聲引導(dǎo)下行雙側(cè)TAPB,DR組予右美托咪定1μg/kg混合0.25%羅哌卡因共40ml,R組給予0.25%羅哌卡因40ml,每側(cè)各20ml�；颊咝g(shù)后均使用舒芬太尼靜脈自控鎮(zhèn)痛。記錄麻醉藥物用量、患者蘇醒時間和拔出喉罩時間。比較兩組患者術(shù)后2(T1)、4(T2)、8(T3)、12(T4)和24h(T5)的Ramsay鎮(zhèn)靜評分、靜息和活動時VAS疼痛評分。記錄術(shù)后24h阿片類藥物的用量及不良反應(yīng)發(fā)生情況。結(jié)果與R組相比,DR組丙泊酚和雷米芬太尼用量減少,患者蘇醒時間和拔除喉罩時間縮短,T1、T2、T3時靜息和活動VAS疼痛評分降低,24h阿片類用藥量和惡心、嘔吐發(fā)生率降低(P0.05)。兩組Ramsay鎮(zhèn)靜評分差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論全麻下子宮切除術(shù)患者采用右美托咪定混合羅哌卡因TAPB麻醉恢復(fù)快,術(shù)后鎮(zhèn)痛作用強,阿片類藥物用量和不良反應(yīng)少。
[Abstract]:Objective to investigate the effect of dexmedetomidine combined with ropivacaine transversus abdominis plane block (TAPB) resection in patients under general anesthesia. Methods of uterine hysterectomy under general anesthesia for 60 cases of patients were randomly divided into ropivacaine group (group R) and dexmedetomidine mixed ropivacaine group (DR group). Two groups were induced in the end after ultrasound-guided bilateral TAPB, DR group was treated with dexmedetomidine 1 g/kg 0.25% ropivacaine mixed 40ml, R group was given 0.25% ropivacaine 40ml, intravenous patient-controlled analgesia with sufentanil were used in each side of the 20ml. patients after operation. Anesthesia medication dosage, recovery time of patients and LMA extubation time of patients compared with two. After the group 2 (T1), 4 (T2), 8 (T3), 12 (T4) and 24h (T5) Ramsay sedation score, VAS pain score and resting activities. Records of the occurrence of postoperative 24h opioid dosage and adverse reactions. Results compared with R group, DR group of propofol Reduce and remifentanil dosage, recovery time and shorten the time of pulling out the laryngeal mask in patients, T1, T2, and VAS activity decreased resting pain score T3, 24h opioid dosage and reduce the incidence of nausea and vomiting (P0.05). The two groups had no statistically significant Ramsay sedation score (P0.05). Conclusion the uterus under general anesthesia excision of patients using dexmedetomidine mixed TAPB ropivacaine anesthesia recovery, postoperative analgesia, opioid consumption and less adverse reactions.

【作者單位】： 南京醫(yī)科大學(xué)附屬南京醫(yī)院(南京市第一醫(yī)院)麻醉科;
【分類號】：R614

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