本文選題：右美托咪定 + 羅哌卡因　； 參考：《中國(guó)新藥與臨床雜志》2017年06期

【摘要】：目的觀察右美托咪定不同用藥方式對(duì)全膝關(guān)節(jié)置換術(shù)患者術(shù)后鎮(zhèn)痛的效果,并探討右美托咪定在周圍神經(jīng)發(fā)揮作用的機(jī)制。方法選擇在氣管插管全麻下行單側(cè)全膝關(guān)節(jié)置換術(shù)患者90例,ASAⅠ~Ⅱ級(jí),隨機(jī)分為三組(n=30):右美托咪定混合羅哌卡因行股神經(jīng)阻滯組(A組),肌內(nèi)注射(肌注)右美托咪定聯(lián)合羅哌卡因行股神經(jīng)阻滯組(B組),單純用羅哌卡因行股神經(jīng)阻滯組(C組)。術(shù)后當(dāng)患者靜息VAS評(píng)分≥3分時(shí)使用舒芬太尼患者自控靜脈鎮(zhèn)痛泵,并維持患者術(shù)后VAS評(píng)分≤5分。觀察并記錄術(shù)后第一次使用鎮(zhèn)痛泵時(shí)間、術(shù)后24 h鎮(zhèn)痛泵內(nèi)舒芬太尼用量及鎮(zhèn)痛泵按壓次數(shù),記錄患者術(shù)后24 h內(nèi)不良反應(yīng)發(fā)生情況。結(jié)果與B、C組比較,A組患者術(shù)后第一次使用鎮(zhèn)痛泵的時(shí)間延長(zhǎng),術(shù)后24 h鎮(zhèn)痛泵內(nèi)舒芬太尼用量以及鎮(zhèn)痛泵按壓次數(shù)減少,差異有顯著意義(P0.05);B組和C組比較,患者術(shù)后第一次使用鎮(zhèn)痛泵時(shí)間、術(shù)后24 h鎮(zhèn)痛泵內(nèi)舒芬太尼用量及鎮(zhèn)痛泵按壓次數(shù)無(wú)顯著差異(P0.05)。三組術(shù)后24 h內(nèi)高血壓、低血壓、心動(dòng)過(guò)緩等發(fā)生率比較差異均無(wú)顯著意義(P0.05)。結(jié)論與肌注右美托咪定相比,右美托咪定混合羅哌卡因行股神經(jīng)阻滯能延長(zhǎng)術(shù)后鎮(zhèn)痛的作用時(shí)間,減少術(shù)后靜脈鎮(zhèn)痛藥物的使用量,適合用于全膝關(guān)節(jié)置換術(shù)患者的術(shù)后鎮(zhèn)痛。
[Abstract]:Objective to observe the analgesic effect of dexmetomidine in patients undergoing total knee arthroplasty (TKA) and to explore the mechanism of dexmetomidine in peripheral nerve.Methods A total of 90 patients undergoing unilateral total knee arthroplasty under tracheal intubation under general anesthesia were enrolled in this study.The rats were randomly divided into three groups: dexmetomidine combined with ropivacaine for femoral nerve block, intramuscular injection of dexmetomidine combined with ropivacaine for femoral nerve block, ropivacaine for femoral nerve block, and ropivacaine for femoral nerve block.After operation, sufentanil patient controlled intravenous analgesia pump was used when the rest VAS score was 鈮，

本文編號(hào)：1755274