【摘要】：目的探討混合右美托咪定(Dex)對(duì)左布比卡因腹橫肌平面阻滯(TAPB)鎮(zhèn)痛效果的影響。方法選擇60例擇期行經(jīng)腹子宮全切患者,隨機(jī)分為對(duì)照組和試驗(yàn)組,每組30例。全麻誘導(dǎo)后行TAPB,對(duì)照組采用0.25%左布比卡因40 m L,試驗(yàn)組在對(duì)照組用藥基礎(chǔ)上合用Dex 0.5μg·kg-1。記錄兩組鎮(zhèn)痛時(shí)間(實(shí)施TAPB至術(shù)后第一次使用患者靜脈自控鎮(zhèn)痛泵的時(shí)間)、術(shù)后24 h鎮(zhèn)痛泵舒芬太尼用量,采用疼痛VAS評(píng)分評(píng)估術(shù)后1、4、8、12、24 h的疼痛程度,觀察記錄兩組不良反應(yīng)發(fā)生情況。結(jié)果試驗(yàn)組鎮(zhèn)痛時(shí)間(905.0±114.2)min,較對(duì)照組明顯延長(zhǎng)[(741.4±105.3)min,P0.05]。術(shù)后24 h內(nèi),舒芬太尼用量試驗(yàn)組為(29.4±1.2)μg,少于對(duì)照組[(47.4±2.0)μg,P0.05],術(shù)后8、12 h靜息狀態(tài)下疼痛VAS評(píng)分試驗(yàn)組低于對(duì)照組(P0.05),且試驗(yàn)組患者滿意度高于對(duì)照組(P0.05)。兩組呼吸抑制、低血壓、心動(dòng)過緩等發(fā)生率無顯著差異(P0.05)。結(jié)論 Dex可延長(zhǎng)左布比卡因TAPB鎮(zhèn)痛時(shí)間,減少術(shù)后鎮(zhèn)痛藥用量,并且未增加不良反應(yīng)的發(fā)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 鹵114.2) min, which was significantly longer than that in the control group [(741.4 鹵105.3) min (P0.05)]. Within 24 hours after operation, the dosage of sufentanil was (29.4 鹵1.2) 渭 g in the experimental group, less than that in the control group [(47.4 鹵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.
【作者單位】： 嘉興學(xué)院附屬婦兒醫(yī)院/嘉興市婦幼保健院麻醉科;
【分類號(hào)】：R614

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